Search Results (677)

Background: Restrictive lung disease (RLD) is a potential complication in type 2 diabetes (T2D), but its relationship with insulin resistance and liver-related metabolic dysfunction remains unclear. This study evaluated the association between lung function and metabolic markers in T2D and retrospectively assessed whether metabolic improvements from dietary intervention were accompanied by changes in lung function. Methods: This cross-sectional analysis included 184 individuals (101 with T2D, 33 with prediabetes, and 50 glucose-tolerant individuals). Lung function parameters—vital capacity (VC), total lung capacity by plethysmography (TLC-B), and diffusion capacity for carbon monoxide (TL_CO)—were assessed alongside metabolic markers including HOMA2-IR, fatty liver index (FLI), NAFLD score, and Fibrosis-4 index (FIB-4). In a subset of 54 T2D participants, lung function was reassessed after six months following either a fasting-mimicking diet (FMD, n = 14), Mediterranean diet (n = 13), or no dietary intervention (n = 27). Results: T2D participants had significantly lower VC and TLC-B compared to glucose-tolerant and prediabetic individuals, with 18–21% falling below clinical thresholds for RLD. Lung volumes were negatively correlated with HOMA2-IR, FLI, NAFLD score, and FIB-4 across the cohort and within the T2D group. Although the FMD intervention led to significant improvements in HOMA2-IR and FLI, no corresponding changes in lung function were observed over the six-month period. Conclusions: Restrictive lung impairment in T2D is associated with insulin resistance and markers of liver steatosis and fibrosis. While short-term dietary interventions can improve metabolic parameters, their effect on lung function may require a longer duration or additional interventions and targeted follow-up. These findings highlight the relevance of pulmonary assessment in individuals with metabolic dysfunction. Full article

Background/Objectives: Understanding the impact of dietary habits in terms of obesity, health outcomes, and functional decline is critical in Europe’s growing elderly population. This study analyzed trends in Mediterranean diet (MD) adherence, obesity prevalence, and grip strength among middle-aged and elderly Europeans using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Methods: Data from four SHARE waves (2015–2022) across 28 countries were analyzed. Dietary patterns were assessed through food frequency questionnaires classifying participants as MD-adherent or non-adherent where adherent implies daily consumption of fruits and vegetables and occasional (3–6 times/week) intake of eggs, beans, legumes, meat, fish, or poultry (an unvalidated definition of the MD pattern). Handgrip strength, a biomarker of functional capacity, was categorized into low, medium, and high groups. Body mass index (BMI), self-perceived health (SPHUS), chronic disease prevalence, and CASP-12 scores (control, autonomy, self-realization, and pleasure evaluated on the 12-item version) were also evaluated. Statistical analyses included descriptive methods, logistic regressions, and multiple imputations to address missing data. Results: A significant majority (74–77%) consumed fruits and vegetables daily, which is consistent with MD principles; however, the high daily intake of dairy products (>50%) indicates limited adherence to the MD, which advocates for moderate consumption of dairy products. Logistic regression indicated that individuals with two or more chronic diseases were more likely to follow the MD (odds ratio [OR] = 1.21, confidence interval [CI] = 1.11–1.32), as were those individuals who rated their SPHUS as very good/excellent ([OR] = 1.42, [CI] = 1.20–1.69). Medium and high maximal handgrip were also strongly and consistently associated with higher odds of MD adherence (Medium: [OR] = 1.44, [CI] = 1.18–1.74; High: [OR] = 1.27, [CI] = 1.10–1.48). Conclusions: The findings suggest that middle-aged and older adults are more likely to adhere to the MD dietary pattern if they have more than two chronic diseases, are physically active, and have a medium or high handgrip. Although an unvalidated definition of the MD dietary pattern was used, the results highlight the importance of implementing targeted dietary strategies for middle-aged and elderly adults. Full article

Objectives: To determine whether plasma concentrations of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) are elevated in adults with prediabetes, we explored their association with tissue advanced glycation end-products (AGEs) and assessed the influence of Mediterranean diet adherence. Methods: This cross-sectional single-centre study included 92 adults with prediabetes and 86 age-/sex-matched normoglycaemic controls. Anthropometry, blood pressure, biochemical indices, and skin autofluorescence-derived AGEs were measured. Serum AEA and 2-AG were quantified by competitive ELISA, while Mediterranean diet adherence was assessed using the Mediterranean Diet Serving Score (MDSS). Results: Prediabetes was associated with higher AEA (p = 0.004) but not 2-AG (p = 0.520). Also, AEA correlated positively with AGE values (r = 0.36; p = 0.002) and increased across AGE-based cardiovascular risk categories. In multivariable models, both prediabetes status and AGE burden independently predicted AEA. Participants achieving MDSS ≥ 14 exhibited lower AEA (p = 0.038); 2-AG remained unaffected. Finally, the multivariable analysis confirmed that both prediabetes (β = 11.9; p = 0.005) and AGE values (β = 0.25; p = 0.003) are positively associated with plasma AEA levels, independent of age, sex, BMI, and fasting plasma glucose levels. Conclusions: Circulating AEA, but not 2-AG, is elevated in prediabetes and independently linked to cumulative AGE burden, suggesting early endocannabinoid activation contributes to cardiometabolic risk. High adherence to a Mediterranean diet may mitigate this dysregulation. Full article

Background/Objectives: Job stress negatively affects physical and psychological health and can lead to behavioral changes such as unhealthy eating. This study aimed to evaluate the relationship between job stress levels, adherence to the Mediterranean diet, and the phytochemical index (PI). Methods: The study included 200 healthy individuals aged 18–50 working at the Tuzla Gum Factory. Data were collected through demographic and dietary questionnaires, two-day 24-h food records, PI values, and anthropometric measurements. Job stress was assessed using the Job Stress Scale, and Mediterranean diet adherence was assessed with the Mediterranean Diet Adherence Questionnaire. Results: Waist and hip circumference, waist/hip ratio, and BMI were significantly higher in individuals with high levels of job stress (p < 0.01). Unskilled workers reported higher stress than professionals (p < 0.01). Significant differences were found in carbohydrate and fiber intake among males and in energy, protein, carbohydrate, and vitamin A intake among females with varying stress levels (p < 0.01). No significant difference in Mediterranean diet adherence was observed between medium and high stress groups. However, women had higher adherence and PI scores than men (p < 0.01). Diet adherence was better among managers than service-sales and technical staff (p < 0.01). PI scores were higher in medium stress than high stress individuals (p < 0.05) and in those with a higher BMI compared to a normal BMI (p < 0.01). Conclusions: Job stress influences both anthropometric parameters and dietary habits. Effective stress management may improve adherence to the Mediterranean diet and phytochemical intake. Workplace strategies supporting healthy eating behaviors are recommended. Full article

Background/Objectives: Traditional dietary screeners face significant limitations: they rely on subjective self-reporting, average intake estimates, and are influenced by a participant’s awareness of being observed—each of which can distort results. These factors reduce both accuracy and reproducibility. The Guide Against Age-Related Disease (GARD) addresses these issues by applying Assembly Theory to objectively quantify food and food behavior (FFB) complexity. This study aims to validate the GARD as a structured, bias-resistant tool for dietary assessment in clinical and research settings. Methods: The GARD survey was administered in an internal medicine clinic within a suburban hospital system in the southeastern U.S. The tool assessed six daily eating windows, scoring high-complexity FFBs (e.g., fresh plants, social eating, fasting) as +1 and low-complexity FFBs (e.g., ultra-processed foods, refined ingredients, distracted eating) as –1. To minimize bias, patients were unaware of scoring criteria and reported only what they ate the previous day, avoiding broad averages. A computer algorithm then scored responses based on complexity, independent of dietary guidelines. Internal (face, convergent, and discriminant) validity was assessed using Spearman rho correlations. Results: Face validation showed high inter-rater agreement using predefined Assembly Index (A_i) and Copy Number (N_i) thresholds. Positive correlations were found between high-complexity diets and behaviors (rho = 0.533–0.565, p < 0.001), while opposing constructs showed moderate negative correlations (rho = –0.363 to −0.425, p < 0.05). GARD scores aligned with established diet patterns: Mediterranean diets averaged +22; Standard American Diet averaged −10. Full article

Background/Objectives: Nutrition in inflammatory bowel disease (IBD) is a central concern for both patients and healthcare professionals, as it plays a key role not only in daily life but also in disease outcomes. The Mediterranean diet represents a healthy dietary pattern that may be suitable in many cases of IBD. Among other factors, health literacy (HL) influences patients’ dietary habits and their ability to follow nutritional recommendations. The aim of this study was to assess HL and dietary patterns in adolescent and pediatric patients with IBD. Methods: We conducted a cross-sectional study that included a total of 99 participants (36 patients with IBD receiving biological therapy recruited from a single center and 63 healthy controls). HL was assessed using the Newest Vital Sign (NVS) tool regardless of disease activity, whereas diet quality was evaluated by the KIDMED questionnaire exclusively in patients in remission. Linear regression models were used to evaluate the effects of sex, age and group (patients vs. control) on NVS and KIDMED scores. Results: Most participants (87.9%) had an adequate HL, which was positively associated with age. While the most harmful dietary habits (such as frequent fast-food consumption) were largely absent in the patient group, KIDMED scores indicated an overall poor diet quality. Conclusions: Although HL increased with age and was generally adequate in this cohort, it did not translate into healthier dietary patterns as measured by the KIDMED score. Further research with larger, more diverse samples is needed to clarify the relationship between HL and dietary adherence in adolescents with IBD. Full article

Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers. Full article

Background: Adequate nutrition is fundamental to the health and performance of young athletes. However, many fail to meet nutritional recommendations. Nutrition education programmes are promising, cost-effective strategies for improving dietary habits. However, research gaps persist, coupled with notable variability amongst the intervention programmes targeting youth athletes. The aim of this study was to assess the nutritional knowledge of Portuguese youth athletes and to evaluate the effectiveness of a nutrition education programme in improving football players’ understanding of a healthy diet. Methods: Participants were recruited from a local football club through public announcement. Male youth football players aged 13 to 18 years, training at least 3 times per week and competing regularly over the past six months, were eligible. The baseline assessment included anthropometric measurements, an assessment of the adherence to the Mediterranean diet using the KIDMED questionnaire, and an assessment of general and sports nutrition knowledge via a structured questionnaire. Following the intervention—comprising three face-to-face educational sessions and two digital infographics—the KIDMED and nutrition knowledge questionnaires were re-administered. Results: A sample of 38 male footballers were eligible for this study. Most participants exhibited a healthy body weight, with a corresponding adequate body composition. The mean KIDMED score indicated moderate adherence to the Mediterranean diet with no statistically significant difference between the baseline and post-intervention (6.79 ± 1.52 versus 6.97 ± 2.01, p > 0.05). There was a significant enhancement in overall nutrition knowledge, accompanied by notable improvements in the comprehension of macro- and micronutrient sources and sports nutrition principles. Conclusions: This pilot programme proved effective in enhancing young football players’ knowledge of nutrient sources and sports nutrition. Full article

Psoriasis is a chronic inflammatory autoimmune disease that causes significant deterioration of the quality of life, and due to its multifactorial causes, it is often difficult to manage. Apart from genetic and environmental components, an important part of its pathophysiology comprises an oxidative stress induction that the standard antioxidative mechanisms of the human body cannot compensate for. Moreover, in many psoriatic patients, there is a documented imbalance between antioxidant and pro-oxidative factors. Usually, psoriasis is evaluated using the Psoriasis Area and Severity Index (PASI) score. It has been demonstrated that dietary choices can lead to significant modification of PASI scores. Hypocaloric diets that are rich in antioxidants are highly effective in this regard, especially when focusing on vegetables and restricting consumption of animal-derived protein. Specific dietary regimens, namely the Mediterranean diet and potentially the ketogenic diet, are very beneficial, in the former case owing in large part to the omega-three fatty acids it provides and its ability to alter gut microbiome, a factor which seems to play a notable role in the pathogenesis of the disease. Another option is the topical application of vitamin D and its analogues, combined with corticosteroids, which can ameliorate the manifestations of psoriasis at the level of the skin. Finally, oral vitamin D supplementation has a positive impact on psoriatic arthritis and can mitigate the risk of associated comorbidities. Full article

Background: A growing body of evidence suggests that diet can modify Parkinson’s disease (PD) outcomes, although there is disagreement about what should be included and excluded in such a diet. Existing evidence suggests that adherence to the MIND and Mediterranean (MEDI) diets are associated with reduced PD symptoms, but only a few variables from the adherence scales are responsible for the statistically observed improvement. Objectives: The goal was to use patient-reported outcomes in a large cohort to identify the foods and dietary patterns (PRO diet) most strongly associated with the fewest PD symptoms over time, and to develop a composite adherence scale to enable comparisons between MEDI, MIND, and PRO. Methods: Data were obtained from the prospective longitudinal natural history study and from Modifiable Variables in Parkinsonism (MVP)—a study designed to identify behaviors associated with patient-reported outcomes (PRO-PD). Upon the completion of the binary and food frequency data collection, using various predictive models and considering congruence with historical data, the PRO diet was created via an iterative process. Our goal was to create a new scale and compare its performance to the existing MIND and MEDI scores. The comparison was made at baseline, using the regression models for PRO-PD and the different scales as the predictors. The models were compared via the Akaike Information Criterion (AIC). To examine whether baseline adherence levels predicted subsequent symptom trajectories, the baseline PRO diet adherence and subsequent slope of progression were evaluated. Results: Data from 2290 individuals with PD were available for this analysis. The Mediterranean and MIND diets showed almost identical effects. For both the diets, the effect they had on non-motor symptoms was about twice the effect on motor symptoms. The slopes for the total PRO-PD for MEDI, MIND, and PRO-21 were −64.20467, −64.04220, and −28.61995, respectively. The AIC value differences were substantial (>2), indicating meaningful improvements in the model fit for total PRO-PD, as follows: MEDI: 28,897.24, MIND: 28,793.08, and PRO-21: 27,500.71. The subset of individuals who were most adherent to the PRO-21 diet at baseline had the slowest subsequent progression, as measured by a 43% reduced PRO-PD slope, compared to the less adherent groups. Conclusions: The PRO-21 outperformed the MIND and MEDI diets in the model fit, overcoming the ceiling effects and showing orders of magnitude and superior explanatory power for variance in PD outcomes, despite the smaller per-unit effect sizes. However, its rigorous demands may introduce barriers related to cost, feasibility, and sustainability, underscoring the need for future intervention trials to assess real-world feasibility, adherence, side effects, and clinical impact. Full article

Objective: This study sought to examine the correlation between physical activity levels and various psychological and nutritional factors associated with the risk of developing eating disorders among female university students in the Health Sciences discipline. Method: The study assessed body image, self-esteem, nutritional status, adherence to the Mediterranean diet, and attitudes toward food in a sample of 96 women, categorized into two groups based on their level of physical activity. Results: Significant differences in skeletal muscle mass were identified between the groups, alongside associations between body dissatisfaction, low self-esteem, and elevated EAT-26 scores. Furthermore, students with higher levels of physical activity exhibited a significantly increased prevalence of eating disorder risk. Logistic regression analysis identified body dissatisfaction as a significant predictor of eating disorder risk, while membership in the group with the highest physical activity levels enhanced model fit and increased eating disorder risk. Conclusions: These findings indicate that, while physical activity is associated with certain benefits related to body composition and eating habits, it may also be linked to a heightened risk of disordered eating behaviors, contingent upon the underlying motivations and body perceptions involved. This study highlights the necessity for comprehensive preventive strategies that address both the physical and psychological dimensions of physical activity in female university students. Full article

There is a confirmed and ongoing need to encourage adherence to healthy dietary patterns in the general population in western societies, given their recognized positive impact in preventing non-communicable diseases (NCDs). A potentially very effective solution is the use of digital tools such as apps and web apps, which can reach a large number of people quickly. Still, to be effective, it is necessary to better understand how participant engagement in these interventions works, to identify the motivations that may lead them to drop out, and to evaluate the effectiveness of these interventions. In our study, an innovative web app designed to encourage adherence to the Mediterranean diet (EATMED) was tested in an intervention study, evaluating adherence to the Mediterranean diet before and after the use of the web app in a cohort of people, compared to a control group, using the MEDI-lite questionnaire. The Health and Taste Attitude Scale questionnaire was also administered to all participants to assess interest in healthy foods and diets, as well as attitudes toward food. The study showed that the score of the Food as Reward subscale of the HTAS had a significant effect on dropout from the intervention study, and that the use of the app among participants who remained resulted in a two-point increase in adherence to the Mediterranean diet, according to the MEDI-lite questionnaire. These results indicate the effectiveness of the EATMED tool and provide useful insights into how to understand and mitigate dropout in digital nutrition interventions. Full article

Background/Objectives: The role of maternal diet in atopic dermatitis (AD) requires better understanding, as AD often manifests early in life and precedes other allergic diseases. We evaluated the association between maternal diet and AD up to 2 years of age. Methods: A total of 116 mother–child dyads from the CARE birth cohort study were included. Maternal diet during pregnancy was assessed with a validated self-administered 97-item food frequency questionnaire, and dietary scores were calculated. AD was evaluated at ages 4 months, 1 year, and 2 years. The associations between maternal dietary patterns and AD were examined by logistic regression analysis adjusting for total energy intake, gender of the child, maternal antibiotic therapy during pregnancy, and history of atopic disease among both parents. Results: Of the 116 children, 27 (23.3%) developed AD by 2 years, 11 of whom (40.7%) had persistent AD within the first 2 years. AD risk was reduced with a higher Mediterranean diet score during pregnancy (upper median > 3 points versus lower median: adjusted OR 0.24, 95% CI 0.08–0.69, p = 0.009) and with greater dietary diversity, as measured by the number of items consumed (upper median > 53 items versus lower median: OR 0.19, 95% CI 0.06–0.58, p = 0.005). No association was found with macronutrients and micronutrients. Red meat consumption showed a positive association with the persistent AD phenotype (adjusted OR 5.04, 95% CI 1.47 to 31.36, p = 0.034). Conclusions: Adherence to a Mediterranean diet and a diverse diet during pregnancy may decrease the risk of developing early childhood AD. This highlights the synergistic role of nutrients in dietary patterns as they modulate immune development and disease susceptibility. Full article

Background/Objectives: The Mediterranean diet (MD) is well-studied for its health-promoting effects, while the factors influencing adherence in children remain an important research focus. This study examines the sociodemographic, maternal, perinatal, and lifestyle determinants associated with MD adherence among children aged 6–9 years in an effort to identify key predictors and their impact on long-term nutritional habits. Methods: This study recruited 4851 children from diverse Greek rural and urban regions. The mothers of the enrolled children completed relevant questionnaires on their children’s sociodemographics, perinatal outcomes, anthropometric parameters, breastfeeding practices, and physical activity status. The enrolled children completed the Children’s Depression Inventory (CDI) and the State–Trait Anxiety Inventory for Children—State (STAIC-S) form to assess the presence of depression and anxiety symptoms, respectively. The KIDMED score was used to assess the MD compliance of the enrolled children. Results: The outcomes demonstrated that higher maternal education and family economic status gravitated toward increased MD adherence (p = 0.0071, p ˂ 0.0001), while exclusive breastfeeding (p ˂ 0.0001) and higher physical activity levels (p = 0.0101) were strong predictive factors for MD adherence, highlighting the role of early-life interventions in shaping dietary habits. In contrast, cesarean delivery (p = 0.0173) and higher birth weight (p ˂ 0.0001) were linked to lower MD adherence, indicating potential metabolic and behavioral predispositions. Notably, higher MD adherence correlated with lower prevalence of depressive and anxiety symptoms (p ˂ 0.0001, p = 0.0001), underscoring its potential protective role in mental health. Conclusions: Our findings highlight a complex interplay between early-life and dietary behaviors, while further longitudinal studies are needed to establish causality and optimize evidence-based nutritional strategies and education for childhood health and well-being. Full article

Contextualization: Lifestyle changes, such as smoking cessation, physical activity, and healthy eating, are essential for the treatment and prevention of cardiovascular diseases. The 2021 update of the European Society of Cardiology (ESC) guidelines highlights the need to investigate the adherence to the Mediterranean diet in patients who have suffered acute myocardial infarction (AMI). Objective: The aim of this study was to investigate the adherence to the Mediterranean diet and dietary 2021 ESC guidelines of individuals who have suffered AMI and to evaluate the sociodemographic and lifestyle factors associated with the adherence. Methods: A cross-sectional study was conducted using baseline data from participants prior to enrollment in the DICA-NUTS multicenter clinical trial. The dietary intake was assessed using a food frequency questionnaire and 24 h dietary recall. The nutrient intake was compared with the nutritional recommendations of the 2021 ESC guidelines, and the adherence to the Mediterranean diet was analyzed using a Mediterranean diet score. Furthermore, the analyses of the factors associated with the Mediterranean diet score and 2021 ESC were performed. Analyses were conducted using Stata Data Analysis and Statistical Software version 15.0. Values were considered statistically significant when the p-value < 0.05. Results: Among 488 participants aged ≥ 40 years, moderate adherence to the Mediterranean diet was observed obtaining an average of nine points, with a low intake of vegetables, fish, and cereals. The protein intake was adequate with 18% (interquartile range [IQR] 15.0–23.1) of the total energy value, and the saturated fat intake was high with 9.7% (IQR 7.3–12.7) of the total energy value, while the carbohydrate and total fat intake was adequate. According to the 2021 ESC guidelines, the fiber intake was low with more than 79% of the sample consuming less than 30 g per day. The multivariate analysis using the 2021 ESC dietary recommendations showed that older age (≥60 years) [odds ratio (OR) = 1.63; 95% confidential interval (CI) = 1.44–1.91], never smoking (OR = 1.34; 95% CI = 1.17–1.65), and higher education (OR = 1.37; 95% CI = 1.17–1.77) were correlated with an increased fruit and vegetable intake. Non-white, never-smokers, and former smokers were more likely to consume fish. The alcohol scores were higher in older age participants and women. The dairy scores increased with older age, while the cereal scores decreased. No significant association was found for legumes. Conclusions: According to the scores used, the diet of these individuals moderately reflects the Mediterranean characteristics. Analyzing the 2021 ESC dietary recommendations, the studied population was inadequate. This study found different factors associated with an adequate food intake in post-AMI patients. The highlight of this study was that older age is more likely to increase fruit, vegetable, and dairy intake. Full article