Search Results (524)

Background and Objectives: Hypertension in young adulthood is increasingly recognized as a precursor to future cardiovascular disease. Early identification of modifiable risk factors, such as dietary habits, lifestyle behaviors, and psychological indicators, is critical for prevention. This study aimed to examine the elevated clinic blood pressure and associated factors in 19-year-old individuals in Serbia. Materials and Methods: A cross-sectional study was conducted using data from the 2019 Fourth National Health Survey. A total of 212 participants underwent blood pressure measurement, anthropometric assessment, and completed standardized questionnaires on diet, physical activity, depressive symptoms, and sociodemographic characteristics. Blood pressure was classified according to ESC/ESH guidelines. Associations with elevated blood pressure were assessed using chi-square tests and multivariate logistic regression. Results: Most participants had optimal or normal blood pressure, while 18.9% had elevated blood pressure, including high-normal and Grade I–II hypertension. Elevated blood pressure was more prevalent among males and was associated with depressive symptoms. Nutrition status was significantly associated with elevated blood pressure, and some dietary habits like consumption of pure fruit or vegetable juices and the intake of processed meat products. Other socioeconomic factors, eating habits and physical activity were not significantly correlated. In multivariate logistic regression, elevated arterial blood pressure was significantly associated with consuming pure fruit or vegetable juices less than once per week (OR = 3.239; 95% CI: 1.413–7.427) and with consuming processed meat products several times per week in comparison to the daily consumption (OR = 0.325; 95% CI: 0.130–0.812), while no other variables remained statistically significant. Conclusions: Clinically elevated arterial blood pressure is present in a substantial proportion of 19-year-olds. Early lifestyle interventions targeting nutrition and psychological health may prevent progression to hypertension and reduce long-term cardiovascular risk. Full article

Aims: Low-carbohydrate diets (LCDs) are associated with metabolic benefits, but their long-term effects remain uncertain, particularly in Asian populations with traditionally high carbohydrate intake. This study examined LCD patterns and their association with metabolic syndrome (MetS) in Korean adults using nationally representative data from the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Among 9617 adults aged ≥20 years with complete dietary and health data, LCD score was calculated from the percentage of energy derived from carbohydrates (reverse-scored), fats, and proteins, and participants were categorized into high-carbohydrate, moderate-carbohydrate, and low-carbohydrate groups. MetS was defined using an Adult Treatment Panel III and Korean criteria. Survey-weighted logistic regression was applied to assess associations between LCD score and MetS across sequentially adjusted models. Results: MetS prevalence differed significantly across LCD decile groups (LCD1: 9.6%, LCD2: 5.8%, LCD3: 9.7%; p < 0.001). In a minimally adjusted model, LCD decile 3 was associated with higher odds of MetS (OR, 1.14; 95% CI: 1.02–1.27). However, this association was attenuated and became non-significant after further adjustment for key metabolic risk factors. Obesity, blood pressure, fasting glucose, triglycerides, and high-density lipoprotein cholesterol were all strongly associated with MetS (all p < 0.001), and income-related disparities were evident, with lower-income groups showing higher carbohydrate and lower fat and protein intakes. Conclusions: These findings suggest that LCD patterns are not independently associated with MetS once underlying metabolic factors are considered. Public health strategies in Korea would be emphasized by improving nutrient quality, promoting balanced macronutrient intake, and reducing socioeconomic inequalities in diet to mitigate metabolic risk among adults. Full article

Background: Depression in older adults is a multifactorial condition influenced by health status, functional capacity, and lifestyle factors. This study aimed to investigate the individual and combined associations of these factors with late-life depression. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), this study evaluated the associations of general health, chronic conditions, functioning, and lifestyle behaviors (including physical activity, sleep, diet quality, smoking, and alcohol use) with depressive symptoms among U.S. adults 65 years and older. Weighted logistic regression models, accounting for the complex survey design of NHANES, were used to examine the factors both individually and in combination. Results: Depressive symptoms were more prevalent among individuals with poor self-rated health, physical and cognitive functional limitations, hypertension, obesity, current smoking, physical inactivity, and alcohol abstinence. A clear cumulative risk gradient was observed with increasing numbers of risk factors: older adults with six or more risk factors had at least 20-fold higher likelihood of depressive symptoms compared with those with one or no risk factors. Conclusions: These findings highlight the interdependent influences of health, function, and lifestyle on late-life depressive symptoms and underscore the need for integrative prevention and intervention strategies to promote mental well-being in aging populations. Full article

Background: Skin cancer is known to be associated with aging, oxidative stress, and inflammation. The present study aimed to explore the association between PhenoAge, dietary inflammatory index (DII), and dietary oxidative balance index (DOBS) with skin cancer risk. Methods: A total of 474 individuals aged over 20 years who had information on DII, DOBS, PhenoAge, socioeconomic and demographic factors, and self-reported skin cancer, and 16,154 without skin cancer were included in the National Health and Nutrition Examination Survey database (2005–2018). The combination of DII/DOBS was categorized into 3 categories: inflammation- and oxidation-promoting diet, inflammation- and oxidation-reducing diet, and composite diet. We applied logistic regression to estimate odds ratios (ORs) for the association of DII/DOBS and PhenoAge with skin cancer risk, after adjusting for covariates and survey year. Results: PhenoAge was associated with an increased likelihood of skin cancer (OR 1.07, 95% CI 1.06 to 1.08, p < 0.001). DII and DOBS were associated with PhenoAge advancement of OR 1.28 (95% CI 1.20 to 1.36), OR 0.95 (95% CI 0.94 to 0.96), respectively (p < 0.001). After adjusting for all covariates, the comparison between the inflammation–oxidation-promoting diet and the inflammation–oxidation-reducing diet had a positive relationship with skin cancer (OR 2.19, 95% CI 1.29 to 3.72, p = 0.004). PhenoAge mediated 28.06% of the associations between DII/DOBS and skin cancer risk (p < 0.05). The association remained in the subgroup analysis. Conclusion: Our results suggest that an inflammation- and oxidation-promoting diet is related to increased skin cancer risk and may be partly mediated by PhenoAge. Full article

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

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

Background: Healthier between-meal snacks can improve diet quality in the US and globally. Objectives: To assess the impact on diet quality of replacing solid snacks with almonds or adding almonds (30 g) to the diet. Methods: Dietary data for 4333 children (4–19 y) and 10,925 adults (>19 y) came from the National Health and Nutrition Examination Survey (NHANES 2017–23). Nutrient composition data came from the Food and Nutrient Databases for Dietary Studies (FNDDS). Substitution Model 1 replaced all solid snacks with almonds on a per-calorie basis. Model 2 exempted “healthy” snacks. Model 3 added almonds to the observed diet. The Healthy Eating Index (HEI-2020), Nutrient Rich Food Index (NRF), Mean Adequacy Ratio (MAR), and Mean Excess Ratio (MER) were measures of diet quality. Results: Solid snacks provided 329 kcal/day (15.6% of dietary energy), of which 58 kcal came from healthy snacks (2.9%). The 4–13 y age group consumed the most energy from snacks. Diets with almonds replacing solid snacks were lower in added sugar, sodium, and saturated (solid) fat but higher in protein, fiber, mono- and polyunsaturated fats, and magnesium. MAR dietary nutrient density scores were significantly higher, and MER scores were lower. Total HEI-2020 scores rose from 52.4 (observed) to 59.6 (Model 1) and to 60.6 in Model 2_100. The addition of almonds (30 g or 50 g) increased HEI-2020 values to 59.2 and to 61.4, respectively. Several HEI-2020 sub-scores increased as well. The greatest dietary benefits were obtained for children and young adults. Conclusions: Replacing solid snacks with small amounts of almonds led to higher quality modeled food patterns, especially for younger age groups. The DGA 2025–30 should address the inclusion of healthy energy-dense snacks into everyday diets. Full article

Background/Objectives: Frailty represents a critical aging-related condition, but evidence on how different sources of vitamin C relate to frailty risk remains limited. Thus, this study aimed to examine the relationship between frailty risk and sources of vitamin C intake (dietary, including fruit and vegetable (FV) vs. supplemental) among Korean adults. Method: We analyzed data from 9478 adults in the Korea National Health and Nutrition Examination Survey (KNHANES 2018–2019). Frailty was assessed using a modified Fried phenotype. A multivariable logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for frailty according to vitamin C intake source. Results: More than 60% of participants had inadequate FV intake. Significant associations were observed primarily in women. Increased FV intake (OR = 0.44, 95% CI = 0.264–0.731, comparing the highest intake group (fourth quartile, Q4) vs. the lowest intake group (first quartile, Q1)) for dietary vitamin C intake (OR = 0.60, 95% CI = 0.393–0.914, Q4 vs. Q1) and vitamin C intake from FV (OR = 0.54, 95% CI = 0.348–0.851, Q4 vs. Q1), was significantly associated with a lower risk of frailty. Women with inadequate FV intake had a higher risk of frailty (OR = 2.06, 95% CI = 1.34–3.16) compared to those with adequate intake, regardless of vitamin C supplement use. In contrast, vitamin C supplementation was not significantly associated with frailty risk in either men or women. Conclusion: A higher intake of FV and dietary vitamin C, but not supplemental vitamin C, was associated with a lower risk of frailty, particularly among women. These findings suggest that improving overall diet quality through increased FV consumption may be more effective for frailty prevention than relying on single-nutrient supplementation. Full article

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

Background/Objectives: Dietary quality is a driver of metabolic dysfunction-associated steatotic liver disease (MASLD). Men and women often have different levels of adherence to medical advice, but the effect of gender on adherence to dietary advice as a function of awareness of MASLD is understudied. We aim to investigate the differences in diet quality between men and women who are aware of their diagnosis of MASLD compared to their undiagnosed counterparts. Methods: We utilized the National Health and Nutrition Examination Survey 2017–2020 to identify a nationally representative sample of subjects with MASLD, 127 of whom reported a diagnosis of MASLD (diagnosed MASLD), and 1703 of whom did not report an existing diagnosis of MASLD but met criteria of the disease based on vibration-controlled transient elastography results and cardiometabolic criteria (undiagnosed MASLD). Results: In a gender-stratified analysis of diet quality as a function of reported MASLD diagnosis, women with diagnosed MASLD were more likely than women with undiagnosed MASLD to consume less added sugar and more total and whole fruits. Women with diagnosed MASLD had a 3.06 higher healthy eating index score than undiagnosed women, after adjusting for confounders such as demographics, comorbidities, lifestyle behaviors, and metabolic risk factors. In men, total diet quality did not differ based on awareness of MASLD diagnosis. Conclusions: Women with diagnosed MASLD have superior diets compared to their undiagnosed counterparts. Gender-specific approaches to counseling and prospective studies that investigate causes of gender-driven differences in dietary behavior in the context of MASLD are needed. Full article

Background: Brazil’s dietary patterns and significant socioeconomic and geographic diversity present unique challenges for the prevention of cardiometabolic diseases. Methods: In this cross-sectional study, we analyzed data from a nationwide representative survey to understand how dietary patterns related to cardiometabolic diseases. We classified the dietary pattern of participants as whole plant-based, processed plant-based, and animal-based. Then, they were categorized into high, intermediate, and low consumption. Logistic regression analysis was used to test the prevalence of obesity, hypertension, hypercholesterolemia, diabetes, stroke, and heart diseases according to the level of intake of each of the three dietary patterns. Results: Compared to the low intake of a whole plant-based dietary pattern, a high intake was associated with a lower prevalence of obesity (OR 0.64; 95% CI 0.54, 0.75) and hypercholesterolemia (OR 0.69, 95% CI 0.56, 0.85). A processed plant-based dietary pattern (including items such as soda and sweets) was inversely associated with the prevalence of obesity (OR 0.90; 95% CI 0.83, 0.97), hypertension (OR 0.82; 95% CI 0.76, 0.88), hypercholesterolemia (OR 0.81; 95% CI 0.74, 0.88), and diabetes (OR 0.53; 95% CI 0.48, 0.59). A high intake of animal-based dietary patterns was associated with a lower prevalence of heart diseases (OR: 0.60; 95% CI 0.40, 0.90). Conclusions: In this cross-sectional analysis, greater adherence to specific dietary patterns was associated with differences in the prevalence of cardiometabolic conditions. However, causality cannot be established, and longitudinal studies are warranted to confirm these findings. Full article

In order to understand how health beliefs map onto health behaviors, a national survey, administered in the wake of the COVID-19 campus closures, was conducted to explore college students’ mind-body health beliefs and their health behaviors (across dimensions of physical exercise, diet/nutrition, and socialization). To this end, the Mind-Body Health Screener (MBHS), a five-item, Likert scale, brief measure, was developed. The present study applied an online survey design administered nationally to U.S. undergraduate students during the initial lockdowns with the pandemic (n = 557). To examine the psychometric properties of the MBHS, exploratory and confirmatory factor analyses were run as well as measures of reliability. Furthermore, linear regressions and effect sizes were computed to understand the connection between mind-body health beliefs and behaviors. While initial data supported the psychometric properties of the Mind-Body Health Screener (MBHS) developed for this purpose, substantive results suggested that mind-body health beliefs did not relate to mind-body health behaviors (either before or after the campus closures), aligning with the Cognitive Dissonance Theory. Post hoc analysis did, however, suggest a significant change in health behaviors from pre-campus closures to during the closures, suggesting students engaged in more physical exercise, eating behaviors, and socializing before campus closed, observed with small to large effects. Taken together, the findings of the present study illustrate how the Cognitive Dissonance Theory is a relevant perspective to consider the relation between health beliefs and behaviors during a period of immense stress, such as the COVID-19 initial campus closures. Full article

Background/Objectives: The Planetary Health Diet (PHD) was developed to address global health and environmental challenges by promoting sustainable and nutritionally adequate eating patterns. This study evaluated adherence to the PHD among Korean adults and examined its association with the Korean Healthy Eating Index (KHEI), with the aim of informing the development of a Korea-specific PHD adherence index. Methods: Using data from the 2013–2023 Korea National Health and Nutrition Examination Survey (KNHANES), dietary intake of adults aged ≥19 years was analyzed. Adherence was assessed by comparing food group consumption with PHD reference ranges, and KHEI scores were calculated to examine their association with PHD compliance and nutrient intake. Analyses were also stratified by sex to examine differences in intake patterns. Results: Men generally consumed larger quantities and had higher frequencies of intake across most food groups, whereas women consumed more fruits and dairy products. However, both sexes showed insufficient consumption of whole grains, legumes, and nuts, and red meat intake far exceeded the suggested limits. Participants with higher KHEI scores demonstrated greater intake of plant-based proteins and lower intake of red meat and saturated fats. Nutrient profiles also improved with higher KHEI scores. Conclusions: These findings suggest that better diet quality, as indicated by higher KHEI scores, is aligned with more sustainable eating behaviors and that that the KHEI may serve as a practical proxy for assessing adherence to the PHD. However, persistent gaps in whole grain, legume, and nut intake, together with excessive red meat consumption, highlight the need for culturally adapted guidelines and strategies to promote sustainable dietary shifts in Korea. Full article

Background: Dietary habits are key determinants of physical and mental health, yet large-scale, contemporary data on these behaviors and their health correlates are crucial for effective public health policy. This study leverages a uniquely large dataset to quantify the eating behaviors of Polish adults and examines how these behaviors relate to socio-demographic characteristics, health status, and subjective well-being. Methods: We analyzed data from 1,196,102 adult respondents who participated in the National Poles’ Health Test, a recurring online survey, between 2019 and 2024. The study used self-reported data on dietary habits, socio-demographic variables, chronic conditions, and self-assessed physical and mental health. Descriptive statistics and comparative analyses, such as the chi-square test, Student’s t-test, or ANOVA, were used. Results: Our findings reveal stark socio-demographic disparities in nutrition. Younger respondents and lower educational attainment were strongly correlated with more frequent consumption of fast food and sugar-sweetened beverages. Crucially, these unhealthy eating patterns were significantly associated with poorer self-rated physical and, notably, mental health (among people who consumed fast food every day, as many as 16.6% rated their mental health as bad, and 6.7% as very bad). In contrast, higher vegetable and fruit consumption correlated with markedly better health outcomes and greater subjective well-being. Conclusions: This large-scale study provides evidence of the profound link between diet and both physical and mental well-being in Poland. The results underscore the urgent need for targeted public health strategies aimed at improving dietary behaviors, particularly among younger and less-educated populations. The strong associations between diet, health status, and well-being highlight the importance of integrating nutritional education into both general healthcare and mental health services. Full article

Introduction: Recent guidelines developed by the European Association for the Study of Obesity (EASO) and the European Federation of the Associations of Dietitians (EFAD) focused on the dietetic management of obesity in adults. The present study aimed to explore the perspectives of healthcare professionals regarding these guidelines. Methods: In total, 85 registered dietitians/nutritionists from Greece, the Netherlands, the Republic of Ireland, and the United Kingdom completed an online survey, and 10 were interviewed, in February–March 2023. Demographic data were also collected. Results: Awareness of the EASO-EFAD guidelines among registered dietitians/nutritionists was moderate (57.6%), but only 20% had read them in full. Dietitians with higher education and relevant experience were more likely to have read the guidelines. Less than half reported that key evidence-based recommendations, such as individualized medical nutrition therapy and intensive behavioral interventions, are already included in national guidance. Recommendations like portfolio or DASH diets, partial meal replacements, and calorie restriction were less commonly part of national guidance/usual practice. A small percentage of participants described their adoption of several nutritional approaches novel to them. These included the portfolio dietary pattern, partial meal replacements, and intermittent fasting or continuous calorie restriction. For some Irish dietitians, prioritizing weight as the main outcome conflicted with their emphasis on overall health and individualized nutrition therapy. Other barriers of recommendation implementation included exclusive availability in English, rapid changes in obesity management, staffing shortages, limited multidisciplinary collaboration, and inconsistent knowledge among healthcare providers. Conclusions: The present study identified gaps in the adoption of the EASO-EFAD guidelines into dietetic/clinical practice. EFAD will develop strategies to disseminate these guidelines at different levels of stakeholders (national/local authorities, dietitians/nutritionists, and patients). Full article