Search Results (249)

Background: Nutritional status assessment is the cornerstone of the Nutrition Care Process, guiding diagnosis, intervention, and monitoring. The classical ABCD model (Anthropometry, Biochemical, Clinical, Dietary) has been widely applied; however, it presents limitations in addressing current nutritional and epidemiological challenges. Objective: This narrative review aims to synthesize and update the scientific evidence on the expanded nutritional assessment model, known as ABCDEFG, which incorporates the Ecological–microbiota (E), Functional (F), and Genomic–nutrigenomic (G) approaches. Methods: A narrative review of the literature was conducted through PubMed, Scopus, and Web of Science, covering publications from 2013 to 2025. Articles were selected based on relevance to at least one of the seven assessment domains. Findings were synthesized descriptively and critically, highlighting applications, strengths, and limitations. Results: The ABCDEFG framework offers a multidimensional perspective of nutritional assessment. While anthropometric, biochemical, clinical, and dietary methods remain essential, the inclusion of ecological dimensions (gut microbiota, environmental influences), functional measures (e.g., muscle strength, physical performance), and genomics enables a more sensitive and personalized evaluation. This integrative approach supports better clinical decision-making and research innovation in nutrition and health sciences. Conclusions: The seven-method model broadens the scope of nutritional assessment, bridging traditional and emerging tools. Its application enhances the capacity to identify nutritional risks, design targeted interventions, and advance precision nutrition. Full article

Background: The growing body of evidence linking dietary factors to oral and periodontal health is characterized by substantial heterogeneity in study design, dietary assessment methods, and reported outcomes, warranting a comprehensive narrative synthesis. Diet is a key determinant of oral and periodontal health, influencing inflammation, oxidative stress, salivary composition, and the oral microbiome. Objectives: This narrative review aims to synthesize current clinical, epidemiological, and mechanistic evidence on how dietary patterns and specific nutrients affect oral and periodontal health, focusing on inflammatory pathways, microbiome modulation, nutrient-dependent tissue mechanisms, and clinical outcomes. Methods: A structured narrative search was conducted in PubMed, Scopus, Web of Science, and Google Scholar (2000–2025). Studies examining diet, nutrients, the oral microbiome, caries, gingival inflammation, or periodontal disease were screened through a multistep process, resulting in 98 included articles. Results: High-sugar and ultra-processed diets trigger inflammation and oral dysbiosis, increasing caries and periodontal susceptibility. In contrast, nutrient-rich and anti-inflammatory diets improve immune regulation, support microbial balance, and are associated with better periodontal parameters. Conclusions: Dietary habits significantly shape oral and periodontal outcomes through interconnected metabolic, microbial, and immunological pathways. Integrating targeted nutritional counseling into dental care may strengthen prevention strategies and improve long-term oral health. Full article

Background: Artificial intelligence (AI) is increasingly used in intensive care units (ICUs) to enable personalized care, real-time analytics, and decision support. Nutritional therapy—a major determinant of ICU outcomes—often remains delayed or non-individualized. Objective: This study aimed to review current and emerging AI applications in ICU nutrition, highlighting clinical potential, implementation barriers, and ethical considerations. Methods: A narrative review of English-language literature (January 2018–November 2025) searched in PubMed/MEDLINE, Scopus, and Web of Science, complemented by a pragmatic Google Scholar sweep and backward/forward citation tracking, was conducted. We focused on machine learning (ML), deep learning (DL), natural language processing (NLP), and reinforcement learning (RL) applications for energy/protein estimation, feeding tolerance prediction, complication prevention, and adaptive decision support in critical-care nutrition. Results: AI models can estimate energy/protein needs, optimize EN/PN initiation and composition, predict gastrointestinal (GI) intolerance and metabolic complications, and adapt therapy in real time. Reinforcement learning (RL) and multi-omics integration enable precision nutrition by leveraging longitudinal physiology and biomarker trajectories. Key barriers are data quality/standardization, interoperability, model interpretability, staff training, and governance (privacy, fairness, accountability). Conclusions: With high-quality data, robust oversight, and clinician education, AI can complement human expertise to deliver safer, more targeted ICU nutrition. Implementation should prioritize transparency, equity, and workflow integration. Full article

Background/Objectives: Nutritional patterns influence the gut–brain axis and immune signaling with potential consequences for depression and anxiety. We conducted a review focused on clinically meaningful psychiatric outcomes (symptom severity/diagnosis) to synthesize recent evidence (2020–2025) on Mediterranean-style dietary interventions; ultra-processed food (UPF) exposure; and psychobiotic/prebiotic strategies, integrating mechanistic insights relevant to practice. Methods: Searches in PubMed/MEDLINE, Scopus, and Web of Science (January 2020–October 2025) combined terms for diet, Mediterranean diet (MD), UPF, microbiota, probiotics, psychobiotics, depression, and anxiety. Eligible designs were randomized/controlled trials (RCTs), prospective cohorts, and systematic reviews/meta-analyses reporting clinical psychiatric outcomes in adults. We prioritized high-quality quantitative syntheses and recent RCTs; data were extracted into a prespecified matrix and synthesized narratively. Results: Recent systematic reviews/meta-analyses support that MD interventions reduce depressive symptoms in adults with major or subthreshold depression, although large, long-term, multicenter RCTs remain a gap. Exposure to UPF is consistently associated with higher risk of common mental disorders and depressive outcomes in large prospective cohorts. Psychobiotics (specific probiotic strains and prebiotics) show small-to-moderate benefits on depressive symptoms across clinical and nonclinical samples, with heterogeneity in strains, dosing, and duration. Mechanistic reviews implicate microbiota-derived metabolites (short-chain fatty acids) and immune–inflammatory signaling (including tryptophan–kynurenine pathways) as plausible mediators. Conclusions: Clinically, emphasizing Mediterranean-style dietary patterns, reducing UPF intake, and considering targeted psychobiotics may complement standard psychiatric care for depression. Future work should prioritize adequately powered, longer RCTs with standardized dietary protocols and microbiome-informed stratification to clarify responders and mechanisms. Full article

Background/Objectives: Population aging in Europe presents significant healthcare, economic, and social challenges, particularly in the care of individuals with chronic diseases and frailty. Advance Care Planning (ACP) fosters patient autonomy and aligns end-of-life care with individual preferences. This study aimed to evaluate the acceptability and feasibility of an ACP model in nursing homes. Secondary objectives included exploring clinical characteristics of participants and assessing how frailty is associated with residents’ care goals and preferences. Methods: A prospective observational study was conducted among long-term residents of a Spanish nursing home in 2023. ACP was offered to all new permanent residents, with outcomes assessed through quarterly follow-ups. Acceptance rates, care preferences, and resident satisfaction were primary measures. Clinical data, frailty, functional status, cognitive assessments, and nutritional status were analyzed. The model of ACP is structured into three progressive levels: (1) identification of patients’ values, preferences, and global goals of care; (2) decision-making regarding specific clinical interventions in acute situations; and (3) end-of-life care preferences, including preferred place of death, desired companionship, and comfort-focused measures. Results: From 79 new residents admitted, 93.7% accepted ACP. The process required an average of 139 min to complete, distributed over 3–4 sessions. The main documented preferences included do-not-resuscitate orders (CPR) (79%), hospital transfer decisions (50%), and other individualized care choices. When stratified by frailty level, which was categorized as low, moderate, or high—we observed a clear gradient in care preferences. CPR preference increased from 59.3% (Low) to 87.5% (Moderate) and 95.2% (High). Preference to avoid hospital transfer rose from 22.2% to 50.0% and 85.7%, respectively. Avoidance of instrumentalization increased from 56.2% to 85.0% and 95.0%. Conclusions: ACP in nursing homes is highly acceptable and feasible, with benefits in aligning care with patient preferences and enhancing satisfaction. Full article

The increasing demand for sustainable food requires the development of raw materials and products that provide not only high-quality proteins but also valuable lipids. The aim of this study was to compare the lipid quality of insect powders with that of selected cereal flours (millet, oat, and rice) during four months of storage at room temperature. To simulate increased oxidative conditions, the packages were filled only halfway, thereby increasing oxygen availability. Lipids were extracted using the Bligh–Dyer method, and their oxidation status was assessed based on peroxide value (PV), p-anisidine value (p-AsV), and the total oxidation (Totox) index. Fatty acid composition, antioxidant activity, and oxidative stability were determined using differential scanning calorimetry (DSC). Directly after purchase, none of the analyzed flours or insect powders exceeded a PV of 10 meq O₂/kg lipids or a p-AsV of 20. After four months of storage, lipid oxidation increased in all samples, with changes ranging from 4.6% to 30%, depending on the parameter analyzed. Lipids extracted from insect powders consistently showed significantly higher oxidation levels than those from cereal flours. The proportion of PUFAs in the lipids of the flours ranged from 36.40% to 64.21%, whereas in insect powders it ranged from 30.01% to 37.29%. After storage, only minor changes in PUFA content were observed, and these did not indicate advanced destructive oxidative degradation. Overall, the lipids present in the analyzed flours demonstrated favorable nutritional quality indices, including AI (0.10–0.48), h/H (2.23–10.47), and TI (0.22–1.14). The results indicate that insect powders can serve as a valuable source of fatty acids; however, their susceptibility to lipid oxidation necessitates careful consideration during processing and storage. Full article

Background: Transition from paediatric to adult care in congenital heart disease (CHD) represents a pivotal and vulnerable phase that critically influences long-term survival, morbidity, and quality of life. Advances in paediatric cardiology and surgery have generated a rapidly growing population of adults with congenital heart disease who exhibit complex, lifelong, and multidisciplinary needs. However, survival does not equate to cure, and discontinuity of care during adolescence remains a major predictor of adverse outcomes. Despite widespread recognition of their importance, transition programmes are heterogeneous worldwide, and standardised, evidence-based protocols are missing. Objective: This review calls for action acknowledging the urgent need for structured and standardised transition programmes in CHD care, integrating the key elements that should be addressed in any programme to optimise outcomes. Content: Transition should be understood as a multidisciplinary, longitudinal process integrating medical management, patient and family education, psychological preparation, and societal inclusion. Core domains include tailored physical activity, nutritional counselling, cardiovascular risk factor management, infective endocarditis prevention, reproductive health, psychosocial support, and engagement of primary care providers, educators, and employers. Evidence demonstrates that structured transition programmes enhance health literacy, adherence, and self-management, while reducing loss to follow-up. The active involvement of primary care providers, psychologists, educators, and employers is essential to sustain holistic and equitable care. Conclusions: Transition should be reframed as an essential, lifelong component of CHD care. The development and implementation of standardised, multidisciplinary, evidence-based transition protocols are urgently required to ensure continuity, empower patients, and optimise long-term clinical and psychosocial outcomes for adults with CHD. Full article

Reference intervals for clinical chemistry blood parameters are valuable for both individual diagnostics for animals in managed or veterinary care, and for evaluating wild population health. However, for marine mammals obtaining sufficient data from suitable groups or populations is logistically difficult. Here, we have assembled a large dataset of clinical chemistry results from free-living adult UK harbour seals (Phoca vitulina), analysed in the same commercial laboratory. We applied an open-source algorithm (available as the R package refineR, R version 4.5.2, refineR version 2.0.0) to produce robust reference intervals from these Real-World Data. This novel approach resulted in the generation of 95% reference intervals with 90% confidence bounds for 18 key chemistry parameters indicative of a range of physiological processes including, inflammation, nutritional status, kidney function and liver function. Reference intervals were also generated for triiodothyronine, the active thyroid hormone important in the regulation of metabolism. These intervals will provide critical baseline data for the assessment of harbour seal health as, to our knowledge, this is the largest dataset on which clinical chemistry reference intervals from wild-caught adult harbour seals have been based. Full article

Background/objectives: The nutrition care process (NCP) is an evidence-based practice framework used in Medical Nutrition Therapy for the prevention, treatment, and management of non-communicable chronic health conditions. This review aimed to explore available artificial intelligence (AI)-integrated technologies across the NCP in dietetic primary care, their uses, and their impacts on the NCP and patient outcomes. Method: Six databases were searched: MEDLINE, Embase, PsycINFO, Scopus, IEEE, and ACM digital library. Eligible studies were published between January 2007 and August 2024 and included human adult studies, AI-integrated technologies in the dietetic primary care setting, and patient-related outcomes. Extracted details focused on participant characteristics, dietitian involvement, and the type of AI system and its application in the NCP. Results: Ninety-seven studies were included. Three different AI systems (image or audio recognition, chatbots, and recommendation systems) were found. These were implemented in web-based or smartphone applications, wearable sensor systems, smart utensils, and software. Most AI-integrated technologies could be incorporated into one or more NCP stages. Seventy-nine studies reported user- or patient-related outcomes, with mixed findings, but all highlighted efficiencies of using AI. Higher patient engagement was observed with Chatbots. Seventeen studies raised concerns encompassing ethics and patient safety. Conclusions: AI systems show promise as a clinical support tool across most stages of the NCP. Whilst they have varying degrees of accuracy, AI demonstrates potential in improving efficiency, supporting personalised nutrition, and enhancing chronic disease management outcomes. Integrating AI education into dietetic training and professional development will be essential to ensure safe and effective use in practice. Full article

Background/Objectives: Nutrition during the reproductive years shapes women’s immediate health, fertility, pregnancy outcomes, and long-term offspring well-being. This position paper narratively synthesizes and critically appraises evidence on how dietary patterns, macro-/micronutrients, and supplementation influence women’s health, female fertility, and reproductive outcomes, to inform practical recommendations. Methods: We narratively reviewed recent reviews, cohort studies, clinical trials, and public-health guidance on macronutrients, key micronutrients, dietary patterns (with emphasis on the Mediterranean diet), ultra-processed food (UPF) intake, and targeted supplementation relevant to menstrual, metabolic, cardiovascular, skeletal, and reproductive outcomes. Results: Balanced, diverse diets rich in whole and minimally processed foods support hormonal regulation, ovulatory function, healthy gestation, and chronic-disease risk reduction. Priority nutrients include iron, folate, calcium, vitamin D, zinc, vitamin B12, and long-chain omega-3s (DHA), with supplementation considered when dietary intake or bioavailability is inadequate. Evidence consistently links Mediterranean-style eating to improved metabolic health, insulin sensitivity, IVF success, lower gestational diabetes risk, and favorable neonatal outcomes. High UPF consumption is associated with poorer diet quality, inflammation, adverse pregnancy outcomes, and potential reproductive impairment, warranting a reduction in favor of nutrient-dense foods. Diet also influences cardiovascular and bone health through effects on lipids, glycemia, blood pressure, and mineral/vitamin status, with fiber-rich carbohydrates, unsaturated fats (notably olive oil), and adequate calcium–vitamin D emerging as central levers. Conclusions: For women of childbearing age, a Mediterranean-aligned, minimally processed dietary pattern—tailored to individual needs and complemented by prudent use of folate, iron, vitamin D, calcium, B12, and DHA when indicated—offers robust benefits across reproductive, metabolic, cardiovascular, and skeletal domains. Public-health actions should improve access to healthy foods, curb UPF marketing, and embed personalized nutrition counseling in routine care; further longitudinal research from preconception through postpartum is needed. Full article

Objective: To implement a neonatal iron deficiency (ID) guideline as part of a neuroprotective strategy using reticulocyte hemoglobin content (RET-He) for neonates born <33 weeks postmenstrual age (PMA) and small for gestational age (SGA) neonates ≥33 weeks PMA, to achieve ≥80% screening rate by June 2024. Methods: An interdisciplinary team conducted a quality improvement initiative in a level III neonatal intensive care unit (NICU) from April 2022 to August 2024. RET-He is a validated, sensitive marker of early iron deficiency reflecting recent iron supply for erythropoiesis and providing a more reliable measure than ferritin. The primary outcome was RET-He screening at 30 ± 7 days for neonates <33 weeks PMA or pre-discharge for SGA neonates ≥33 weeks PMA. Exclusion criteria were death or transfer before eligibility. Process measures included ID screening failure rate (RET-He level < 29 pg). Results: Of 345 eligible neonates, P-chart analysis showed screening rates for premature neonates <33 weeks PMA declined during PDSA 1–2, before improving to 85.9% in PDSA 3. ID screening failure was 12.6% at one month, increasing to 32.1% at two months. For SGA neonates ≥33 weeks PMA, screening rates remained low, peaking at 36% in PDSA 3, with a 2.2% failure rate. Conclusions: Implementation of a RET-He based ID guideline improved screening rates for premature neonates but was less effective for SGA neonates. Despite improved guideline adherence, ID prevalence remained high at NICU discharge, indicating a further need to improve nutritional prevention and treatment strategies. Full article

Background/Objectives: Eating disorders (EDs) frequently emerge during critical stages of childhood and adolescence, when identity development and emotional regulation are still maturing. Disturbances in self-concept clarity and identity integration may transform the body into a symbolic battlefield for autonomy, belonging, and self-worth. This review synthesizes developmental, psychosocial, neurocognitive, and therapeutic perspectives on the role of identity disturbance in EDs. Methods: A narrative review was conducted (2010–2025) using combinations of terms related to identity, self-concept clarity, self-discrepancy, objectification, interoception, and eating disorders (anorexia nervosa, bulimia nervosa, and binge-eating disorder). Results: Findings indicate that identity vulnerability (expressed as low self-concept clarity, heightened self-discrepancies, and self-objectification) mediates the association between early adversity, sociocultural pressures, and ED symptoms. Neurocognitive studies reveal altered self-referential processing, default mode network connectivity, and interoceptive signaling. Clinically, comorbid borderline personality features further exacerbate identity disturbance and complicate recovery. Evidence-based treatments such as enhanced cognitive-behavioral therapy (CBT-E) effectively target core maintaining mechanisms, while adjunctive interventions (mentalization-based therapy, schema therapy, narrative approaches, and compassion- or acceptance-based methods) show promise in addressing identity-related processes and improving outcomes. Conclusions: Identity disturbance provides a unifying framework for understanding why ED symptoms become entrenched despite adverse consequences. Integrating identity-focused approaches with nutritional and medical care may enhance recovery and reduce chronicity in youth. Future research should adopt longitudinal and mechanistic designs to clarify pathways linking identity change to clinical improvement and test identity-specific augmentations to standard ED treatments. Full article

Background/Objectives: The identification of health risk factors in children should rely not only on body mass index but also on modifiable lifestyle behaviors. Early screening for physical inactivity, poor nutrition, inadequate sleep, and chronic stress is crucial for effective preventive healthcare. The aim of this project was to develop the OWL screening tool, a protocol for the holistic assessment of key lifestyle risk factors in children aged 6–12. Methods/Rationale: The OWL tool was developed by integrating evidence-based recommendations from major health societies (WHO, EFSA, the National Sleep Foundation, and the Pediatric Endocrine Society), incorporating psychological principles, and adapting validated components from existing pediatric screening instruments. Its design prioritizes flexibility for use across various age groups and settings. The development process resulted in the 20-item OWL questionnaire, structured into four lifestyle domains: nutrition, physical activity, sleep, and stress management. Each item is a closed-ended question requiring a dichotomous (yes/no) response. One point is awarded for each health-promoting behavior endorsed, yielding a total possible score of 20. The tool is suitable for self-report by older children, parent-report for younger children, or clinician-administered review. Conclusions: By integrating sleep and stress management with traditional lifestyle factors, the OWL screening tool offers a highly relevant approach to pediatric preventive care. The findings presented here should be interpreted as a proof-of-concept, and the tool is not yet ready for clinical implementation without further rigorous evaluation. Full article

Cancer remains a primary global health concern, with treatment-related side effects and malnutrition posing significant challenges to patient care and recovery. In recent years, there has been growing interest in the therapeutic potential of functional food components, especially whey proteins (WPs), due to their notable antioxidant, immunomodulatory, and anticancer properties. This systematic review explores the effects of WPs across various cancer types and assesses their value as supportive nutritional agents. A thorough literature search was conducted in PubMed, Scopus, and Web of Science databases, identifying 24 relevant studies published between 2000 and 2024. The selection process followed PRISMA guidelines. The evidence, drawn from both laboratory and clinical research, suggests that WPs may exert anticancer effects by inhibiting tumor cell growth, promoting apoptosis, enhancing antioxidant defenses, modulating immune activity, and influencing signaling pathways such as the PI3K/Akt, mTOR, and Wnt/β-catenin pathways. Colorectal, breast, and liver cancers emerged as the most extensively studied types. Additionally, the form of WP used—whether concentrate, isolate, or hydrolysate—appeared to influence both biological activity and clinical outcomes. Clinical findings suggest that WP supplementation may support nutritional status, mitigate the adverse effects of chemotherapy, and enhance the quality of life in cancer patients. While the preclinical data are compelling, further high-quality randomized controlled trials are needed to confirm these benefits and determine optimal use in clinical practice. This review highlights WPs as promising, well-tolerated nutritional agents with potential to enhance current cancer care strategies. Full article

The Food Energy Intake (FEI) method is among the most widely used approaches for establishing income poverty lines, particularly in low- and middle-income countries where it is often used as a baseline to define official poverty lines. This method links poverty measurement to the consumption of calories and other essential nutrients, identifying households that lack the resources necessary to meet minimum nutritional requirements. However, due to data limitations, the construction of poverty lines based on the FEI method relies on a series of assumptions that are often left to the discretion of specialists, without adequate discussion regarding their appropriateness or potential implications. These assumptions can significantly influence the resulting poverty lines and, consequently, the poverty estimates derived from them. In this study, we focus on the Mexican official method of poverty measurement to explore an often overlooked step in poverty measurement: the treatment of extreme values in nutrient availability estimates constructed using household survey data. While this may initially appear to be a minor technical consideration, we demonstrate that the criteria used to identify and potentially exclude outlying observations exert a substantial influence on poverty metrics, which reveals weak fulfillment of the FEI assumptions, as well as important limitations in the expenditure data. This underscores the critical importance of adopting transparent, rigorous, and consistent methodologies for managing outliers, alongside a careful evaluation of other assumptions that are commonly overlooked during the poverty line construction process. We assess the sensitivity of poverty estimates in Mexico employing twelve different outlier-handling methodologies. For each method, we compute the corresponding poverty lines and poverty rates. Our findings reveal substantial variation in extreme poverty rates—ranging from 10.7% to 26.7%—solely attributable to the criteria adopted for the treatment of extreme values. Our analysis suggests that such sensitivity may originate in the decision to use income, rather than expenditure, as the underlying welfare measure in the implementation of the FEI method. We conclude that addressing the treatment of outliers is essential for ensuring consistent and reliable poverty measures, but a thorough revision of the method adopted by the Mexican government to measure poverty is essential. Full article