Search Results (74)

Background: Background: Childhood dietary habits are critical determinants of physical growth, cognitive development, and long-term health. In Ecuador, malnutrition remains a major public health concern, with both undernutrition and overweight/obesity affecting children—especially in rural and indigenous populations. Methods: This systematic review followed PRISMA 2020 guidelines (PROSPERO ID: CRD420251080987). Searches were conducted in SciELO, Dialnet, and ScienceDirect (accessed August 2025) using Boolean operators to identify quantitative studies in Spanish or English published between 2018 and 2025 that assessed dietary habits and nutritional status in Ecuadorian children aged 1–11 years. Seventeen studies, including approximately 12,000 children, were included. Results: Prevalence of chronic undernutrition ranged from 15% to 35%, while overweight and obesity reached 20–30%. Undernutrition was higher among rural and indigenous children, whereas overweight predominated in urban and higher-income settings. Common dietary patterns included high consumption of ultra-processed foods and sugar-sweetened beverages, and insufficient intake of fruits, vegetables, and quality proteins. Maternal education, socioeconomic level, and school food environments were key determinants. Conclusions: Both malnutrition and overweight persist among Ecuadorian children, reflecting a nutrition transition influenced by socioeconomic and environmental factors. Context-specific public health actions are urgently needed, including school-based nutrition education, regulation of food marketing, improved access to affordable healthy foods, and community-level engagement to promote sustainable dietary habits. The included studies were mostly cross-sectional and often used non-validated dietary assessment tools, which may influence the reported prevalence estimates. Full article

Background/Objectives: While many studies have explored the association between circulating branched-chain amino acids (BCAAs) and type 2 diabetes mellitus (T2DM), evidence on the prospective relationship between dietary BCAA intake and T2DM risk remains limited. We aimed to explore this relationship—both total and by dietary source—in a Mediterranean cohort. Methods: We used data from the SUN Project, a prospective and dynamic cohort of Spanish university graduates initiated in 1999. Dietary intake was assessed with a validated 136-item food frequency questionnaire at baseline and at 10 years. BCAA intake (valine, leucine, isoleucine) was estimated using the USDA amino acid database and adjusted for energy intake by the residual method. Participants were followed biennially through questionnaires to identify incident T2DM cases, confirmed by a supplementary questionnaire and medical report, following the ADA diagnostic criteria. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders across four multivariable models. BCAA intake was modeled both categorically (tertiles) and continuously (per 0.5% energy or 5 g/day increase). Analyses were stratified by age and recruitment period. Results: After exclusions, 20,154 participants were included (mean follow-up: 14.67 ± 5.8 years), with 220 incident T2DM cases identified. For each 0.5% energy increment intake from BCAA, there was no association with T2DM (adjusted HR: 1.01; 95% CI: 0.69–1.20). Among men, the adjusted HR was 0.91, 95% CI: 0.69–1.20. Among women, it was 1.40, 95% CI: 0.94–2.09. In the overall cohort, higher BCAA intake showed a non-significant inverse association with the T2DM risk when comparing extreme tertiles (HR = 0.81; 95% CI: 0.48–1.37), which strengthened when repeated dietary measures were considered (HR = 0.70; 95% CI: 0.46–1.06, p-trend = 0.06). Analyses by BCAA sources (animal vs. plant) and stratified by sex, weight status, and age did not reveal consistent patterns, though exploratory findings suggested potential effect modification by sex and adiposity. Sensitivity analyses confirmed the lack of robust associations, with some subgroup-specific signals being limited by low event numbers and wide CIs. Conclusions: Given the power limitations and the modest, non-significant associations observed, these findings should be considered preliminary evidence that may help guide future research on the role of dietary BCAAs in glucose metabolism and diabetes risk. Full article

The COVID-19 pandemic has significantly altered consumer habits, particularly in relation to food choices. In this context, plant-based diets have gained prominence, driven by health, environmental, and ethical considerations. This study investigates the primary motivational and inhibitory factors influencing the consumption of plant-based foods among residents of the Galicia–Northern Portugal Euroregion. Utilizing the Theory of Reasoned Action, an extended model was proposed and tested through a quantitative survey. A total of 214 valid responses were collected via an online questionnaire distributed in Portuguese and Spanish. Linear regression analysis revealed that health awareness, animal welfare, and environmental concern significantly shape positive attitudes, which subsequently affect the intention to consume plant-based foods. Additionally, perceived barriers—such as lack of taste and insufficient information—were found to negatively influence intention. These findings contribute to the consumer behavior literature and provide strategic insights for stakeholders aiming to promote more sustainable dietary patterns in culturally connected cross-border regions. Full article

Background: Sleep is a fundamental component of health, and deprivation has been linked to numerous adverse outcomes, including reduced academic and occupational performance, greater risk of accidents, and increased susceptibility to chronic diseases and premature mortality. Dietary and lifestyle behaviors are increasingly recognized as key determinants of sleep quality. Women are particularly susceptible to sleep disturbances due to hormonal fluctuations and psychosocial factors. However, women remain underrepresented in sleep research. This study aims to examine the associations between sleep quality, nutrition, and lifestyle in a large cohort of Spanish women. Methods: A cross-sectional study was conducted with 785 women aged 18–64. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the NutSo-HH questionnaire on dietary and lifestyle behaviors. Descriptive analyses, correlation matrices, Gaussian Graphical Models, and Principal Component Analyses were used to assess relationships between variables. Results: More than half of the participants rated their sleep quality as good or very good, although over 30% experienced frequent nighttime awakenings. Poor sleep quality was significantly associated with higher alcohol consumption, lower vegetable and white fish intake, and lower levels of physical activity. Diets rich in ultra-processed foods correlated moderately with subjective poor sleep and daytime dysfunction. However, no strong associations were found between stimulant consumption, late meals, or dietary patterns (e.g., Mediterranean diet) and sleep. Self-perceived health emerged as a protective factor, while nocturnal lifestyles were linked to longer sleep latency and fragmented sleep. Conclusions: In adult women, better sleep quality is linked to healthy dietary choices, regular physical activity, and a positive perception of general health. In contrast, alcohol use and irregular lifestyles are associated with poor sleep. Individual variability and cultural adaptation may moderate the impact of some traditionally harmful behaviors. Personalized, multidimensional interventions are recommended for promoting sleep health in women. Full article

Background/Objectives: The nutritional habits of older adults are increasingly relevant to public health, particularly given the rising prevalence of obesity and its associated chronic diseases. This study aims to analyze the relationship between the Healthy Eating Index (IASE) and Body Mass Index (BMI) in older adults in Spain, focusing on food frequency, dietary preferences, and socioeconomic factors influencing nutritional security. Methods: The study is part of the Eating Matters project, assessing food (in)security in older adults across Andalusia and Catalonia between April 2022 and January 2024. A cross-sectional survey was conducted among 190 participants (≥65 years), recruited in primary healthcare centers. The questionnaire included three blocks: food insecurity assessment (FIES scale), diet quality with the Healthy Eating Index for the Spanish Population (IASE), and sociodemographic factors. Data analysis involved descriptive statistics, Pearson correlations, and logistic regression models to identify associated factors with overweight and obesity. Results: The average BMI was 28.5 kg/m² (SD = 4.29), with 46.3% of participants classified as overweight and 32.1% as obese. A significant negative correlation (r = −0.79, p < 0.05) was found between healthy food consumption and BMI, while personal income showed a moderate positive correlation with adherence to a healthy diet (r = 0.42, p < 0.05). Logistic regression indicated that frequent consumption of processed meats and confectionery was a significant identify associated factors with overweight/obesity, with a model accuracy of 68% and sensitivity of 95%. Conclusions: Older adults with lower incomes and higher consumption of ultra-processed foods exhibited a higher risk of obesity. These findings highlight the need for public policies promoting food accessibility and targeted nutrition education for older adults, including guidance on balanced diets, adequate protein intake, and the prevention of sarcopenia, to encourage healthier dietary patterns in aging populations. Full article

Background: Physical activity and nutrition play a crucial role in maintaining overall health and well-being. This cross-sectional study analyzes the relationship between physical activity habits and dietary patterns in the Spanish population. Methods: Data were collected through validated questionnaires: the Nutritional and Social Healthy Habits scale (NutSo-HH) for nutritional and lifestyle habits and the Global Physical Activity Questionnaire for physical activity distributed via social media from June to November 2024. Results: The sample included 1534 respondents (67% female), aged 18–65+ years, with diverse educational, income, and living conditions. Socio-demographic, nutritional, lifestyle, and physical activity data were analyzed using non-parametric statistical tests and Principal Component Analysis. On average, participants engaged in 96.7 min/week of high-intensity physical activity and 118 min/week) of moderate-intensity physical activity. While 75% met the WHO recommendations for moderate activity, only 40% reached optimal levels of high-intensity activity. Individuals engaging in higher levels of physical activity, particularly high-intensity exercise, reported better self-perceived health, lower obesophobia, and better body image. Additionally, a positive correlation was found between higher physical activity levels and the consumption of fruits, vegetables, legumes, and fish, while individuals with lower physical activity levels demonstrated a higher intake of ultra-processed and fried foods. Conclusions: The Principal Component Analysis revealed a bidirectional relationship between the alignment of healthy dietary habits and increased physical activity. These findings highlight the importance of promoting both physical activity and balanced nutrition to enhance overall health and lifestyle quality. Full article

Objectives: This study examines the relationship between nutrition, lifestyle habits, and perceived sleep quality in a cross-sectional analysis of 22,181 Spanish adults. Methods: Data were collected between August 2020 and November 2021 using the Nutritional and Social Healthy Habits (NutSo-HH) questionnaire, which assessed variables such as sleep duration, self-perceived restfulness, dietary patterns, and physical activity. Results: Findings indicate that 48.9% of participants sleep 7–8 h per night, while 8.6% sleep less than 6 h. Approximately 50% report frequently feeling rested, whereas 45.4% seldom or sometimes feel rested. Non-parametric Mann–Whitney and Kruskal–Wallis tests with Dwass–Steel–Critchlow–Fligner (DSCF) correction revealed that perceived sleep quality had an average score of 3.39 on a 0–5 scale, with significant differences based on socio-demographic and lifestyle factors (p < 0.001 for sex, age, education, income, and living in a family). Participants with sufficient sleep reported a lower BMI, a higher nutritional index, and more weekly physical activity. A network analysis demonstrated strong clustering between sleep variables and eating behaviors. Although causality cannot be established in this observational study, the results suggest that better sleep is associated with the lower consumption of sugary drinks and ultra-processed foods, as well as improved body image and mental health. Conclusions: These findings highlight the interconnectedness of sleep, nutrition, and lifestyle habits, suggesting that targeted interventions in any of these areas could positively influence the others, ultimately improving overall health outcomes. Full article

Aim: This cross-sectional study examines sociodemographic, nutritional, and lifestyle factors affecting Body Mass Index (BMI) in the Spanish population, with a particular emphasis on obesity. Methods: A sample of 22,181 Spanish residents aged 18 years and older was recruited through digital and physical channels from August 2020 to November 2021. Data were collected using the validated NutSo-HH questionnaire, which includes sections on sociodemographic information, health perceptions, eating habits, and lifestyle factors. Results: Among respondents, 661 (3%) were underweight (BMI < 18.5 kg/m²), 14,562 (65.7%) were normal weight (18.5 kg/m² ≤ BMI ≤ 25 kg/m²), 4825 respondents (21.8%) were overweight (25 kg/m² < BMI ≤ 30 kg/m²), and 2133 (9.6%) were obese (BMI > 30 kg/m²), with significant differences across these groups in relation to diet and lifestyle behaviors. Principal Component Analysis (PCA) was employed to identify the primary variables influencing obesity, revealing that poor dietary habits (frequent consumption of fast food, fried foods, and ultra-processed items) were negatively correlated with healthy behaviors such as regular fish consumption and physical activity. The PCA plot indicated notable distinctions based on educational attainment and age, with individuals with lower educational levels displaying poorer nutritional patterns and younger participants exhibiting higher fast food consumption and poorer sleep quality. Statistical analyses confirmed that sociodemographic factors, including age, education, and income level, significantly influenced BMI. Some differences were also found according to the place of residence. Conclusions: These findings underscore the need for targeted interventions that address both sociodemographic and lifestyle factors to mitigate obesity risk in Spain. Full article

Objectives: This study aimed to evaluate and compare the consumption of dietary supplements (DS) in semi-professional male and professional female Spanish football players. Methods: The study involved 129 football players (92 men and 37 women) who completed a validated, self-administered questionnaire on the use of DS in athletes. Results: The results indicated that 96.12% of the sample reported taking DS, with the main reason for consumption being performance enhancement. The most commonly consumed DS were creatine monohydrate (66.77%), caffeine (56.59%), whey protein (48.06%), isotonic drinks (37.21%), vitamin D (27.91%), energy bars (27.13%), magnesium (20.93%), and vitamin C (20.16%). Additionally, significant differences were found between sexes regarding vitamin D consumption (p < 0.05; OR = 3.27 [0.36–2.00]). According to the Australian Institute of Sport DS classification, group A was the most consumed, followed by group B. Significant sex differences were found in the consumption of sports foods (p = 0.034; OR = 3.25 [0.05–2.31]) and medical supplements (p < 0.001; OR = 3.75 [0.52–2.12]). Sex differences were also found in place of purchase, source of recommendation, as well as the situation and timing of consumption (p < 0.05). Conclusions: The use of DS among Spanish football players was prevalent at 96.12%, with creatine monohydrate, caffeine, and whey protein being the most commonly consumed. Differences in consumption patterns were noted between sexes. Full article

Dietary patterns, such as the Mediterranean diet (MD) and the Western diet (WD), influence gut microbiota composition and functionality, which play important roles in energy metabolism and nutrient absorption. Objectives: A descriptive cross-sectional study was designed to evaluate the gut microbiota of 19 Spanish adolescents and to investigate the association of MD and ultra-processed food (UPF) intake with microbial diversity and community structure. Methods: Functional diversity of gut microbiota was evaluated using Biolog EcoPlates, taxonomic composition was assessed with 16S rRNA sequencing via MinION, and phenotypic responses to antibiotics were analyzed using the cenoantibiogram technique under aerobic and anaerobic conditions. Results: Adolescents with higher adherence to the MD exhibited greater functional diversity, as per the Shannon–Weaver index. In addition, this group showed higher abundance of bacterial genera previously described as beneficial, such as Paraclostridium, Anaerobutyricum, Romboutsia, and Butyricicoccus. In contrast, adolescents reporting greater UPF intakes had a microbiota composition similar to those with low adherence to the MD, characterized by decreased abundance of beneficial genera. Regarding antibiotic resistance, significant differences were only observed under anaerobic conditions, with individuals with low adherence to the MD showing more sensitivity for most antibiotics tested. Conclusions: These results suggest that the MD promotes a healthier and more balanced gut environment, potentially improving metabolic functions in adolescents. Despite the lack of differences in α-diversity, comparisons of microbial community structure between adolescents following the MD and those with high UPF (characteristic of the WD) showed clear differences in terms of β-diversity. These findings suggest that dietary patterns influence the composition of the gut microbiota in a more complex manner, beyond just taxonomic richness. The outcomes of this exploratory study highlight opportunities for future research to deepen understanding of the long-term health implications of these dietary patterns, as well as the mechanisms regulating the composition, functionality, and phenotypic responses to antibiotics of gut microbial communities. Full article

Background/Objectives: The global population is undergoing a significant demographic shift characterised by an increasing proportion of older individuals. Healthy aging has become a priority for personal well-being and sustainable healthcare systems, with nutrition playing a pivotal role. However, the rise in non-communicable diseases (NCDs), malnutrition, and a shift in eating behaviour underscore the need for tailored, effective nutrition communication strategies. This research is intended to provide the basic data needed to support the development of tailored nutritional communication strategies and practices. Methods: To investigate these aspects, a cross-national survey about nutrition and nutrition communication was conducted within the framework of the Innovative Training Network SmartAge, focusing on older adults aged 60 years and above in Germany, Switzerland, Spain, and France (each 25%; N = 1000 persons). This paper specifically focuses on the development, methodology, and discussion of the survey and aims to investigate the characteristics of the sample in relation to their dietary patterns and food choices within the European context. Results: The analysis identified significant associations between various plant- and animal-based food items and the variables gender, age group, and country. Spanish participants showed a dietary pattern towards the Mediterranean Diet, while German participants showed tendencies towards the Western Diet. Furthermore, the findings revealed that protein-rich foods such as meat, fish, nuts and seeds, legumes, and (whole) grains were infrequently consumed, particularly among German and Swiss participants. Conclusions: This study highlights the need to promote adequate protein intake among older adults, emphasising diverse sources like legumes, nuts and seeds, (whole) grains, and lean meats to support healthy aging. For the development of future nutrition communication strategies, the influence of the specific social, cultural, and traditional factors needs to be considered. Full article

Background/Objectives: The water footprint (WF) provides information on the impact of individual foods on water consumption, but to better direct food production toward water saving, we need to understand how to reduce the WF of our diets while keeping it healthy. In this study, we compared the WF of healthy diets based on national food-based dietary guidelines with the aim of highlighting changes in dietary patterns that could reduce water requirements without compromising nutritional adequacy. Methods: Three 2000 kcal/day dietary patterns were elaborated following the Italian, Spanish, and American dietary guidelines, and their total, green, blue, and grey WFs were calculated. Results: The Italian dietary pattern showed the lowest total WF (2806 L per capita/day), with the American and Spanish patterns being 8% and 10.5% higher, respectively. The food groups contributed differently to the total WF. In the USA, animal foods were the main contributor (56% versus 41% in Spain and 38% in Italy). The contribution of plant foods was higher in Italy (61%) than in Spain (54%) and the USA (38%). The distribution of the total WF between WF_green, WF_blue, and WF_grey was similar across the dietary patterns. Within each food group, and mainly in the animal-origin food group, the type of product significantly modulated the WF. Conclusions: Different diets can be equally nutritionally sustainable but have different impacts on environmental sustainability. The comparison of their WFs can be the starting point to promote dialogue between nutritionists, operators in the environmental sector, and the agri-food industry to ensure a healthy and balanced approach. Full article

Background and Objectives: Gestational diabetes mellitus (GDM) is one of the most common medical conditions in pregnancy, with adverse effects on maternal and neonatal outcomes. Evidence suggests a beneficial effect of plant-based dietary patterns, rich in foods derived from plant sources and low in animal foods, on type 2 diabetes; however, their effects on GDM remain unclear. We aimed to investigate the association between pre-pregnancy provegetarian food patterns and the incidence of GDM in a Spanish cohort. Materials and Methods: This subsample of the Seguimiento Universidad de Navarra (SUN) cohort analyzed 3589 Spanish university graduate pregnant women with a mean (standard deviation) age of 28 (±4.3) who were initially free of pre-existing diabetes at baseline. Dietary food consumption was evaluated through a validated, 136-item semi-quantitative food frequency questionnaire. The pre-pregnancy provegetarian food pattern was obtained by assigning positive scores to plant-based food groups and reverse scores to animal food groups. Energy-adjusted quintiles were applied to allocate points to construct the provegetarian food pattern, ranging from 12 to 60 points. Logistic regression models were performed to estimate the odds ratios (OR) of GDM across quintiles of a pre-pregnancy provegetarian food pattern, using the lowest quintile as the reference category. Results: We identified 178 incidence cases of GDM. Women in the highest quintile (Q5) of provegetarian food pattern before pregnancy exhibited a 42% relative reduction in the odds of GDM [adjusted OR (95% CI) Q5 vs. Q1: 0.58 (0.35, 0.97); p-trend = 0.109]. Higher consumption of meat and dairy before pregnancy was associated with a significantly increased risk of GDM [adjusted OR (95% CI) Q5 vs. Q1: 1.94 (1.19, 3.16); p-trend = 0.005] and [adjusted OR (95% CI) Q5 vs. Q1: 1.77 (1.07, 2.94); p-trend = 0.082], respectively. Conclusions: Higher pre-pregnancy consumption of a provegetarian food pattern was associated with a lower risk of developing GDM in Spanish women. Further studies are needed to confirm these findings. Full article

Background/Objectives: The Mediterranean diet (MD) is one of the most studied dietary patterns to date and is associated with multiple benefits for health and sustainability. However, paradoxically, adherence to the MD (AMD) has been gradually decreasing in native regions. It is necessary to identify the factors that influence AMD to reverse this trend and to mitigate the negative outcomes (for health and the environment) associated with westernized diets. The objective of this study was to assess how self-perception of dietary behavior influences AMD. Methods: During the 28-day repeated measurement cross-sectional study, participants’ dietary information was obtained from an initial form which established the self-perception of dietary behavior and the e12HR application to establish actual food consumption by individuals. Using the dietary information from both sources, the AMD index was calculated (specifically, the Mediterranean diet Serving Score (MDSS) index). Two categories of self-perception of dietary behavior were defined: Normal/underestimation: difference (MDSS index from initial form—MDSS index from e12HR application) ≤0; and Overestimation: difference >0 (with three subcategories: low (difference = 1–5), moderate (difference = 6–10), high (difference = 11–15)). Results: 139 (111, women; 28, men) Spanish university students were studied, with 98.6% (99.1%, women; 96.4%, men) falling into the overestimation category (they overestimated their dietary behavior); these students had significantly lower MDSS indexes, mean = 6.7, than students in the normal/underestimation category, mean = 12.0. Within the overestimation category, there were significant differences in the MDSS index: low (mean = 8.1), moderate (mean = 6.7), and high (mean = 4.9) subcategories and also differences that were significant in women but not in men. Conclusions: Overestimation of dietary behavior could be associated with lower AMD in all Spanish university students and women. Full article

The objective of this cross-sectional study was to explore sleep patterns and the potential relationship between sleep and tryptophan intake among Spanish university students. A total of 11,485 students self-reported their sleep and dietary patterns and habits. Tryptophan intake was calculated using a food intake matrix and results were presented as quartiles of total intake. Short sleep duration prevalence was 51.0%, with males exhibiting a significantly higher frequency. A total of 55.0% of participants presented inadequate sleep efficiency, with males again presenting a higher rate. Median tryptophan intake was 692.16 ± 246.61 mg/day, 731.84 ± 246.86 mg/day in males and 677.24 ± 244.87 mg/day in females (p = 0.001). Dietary tryptophan intake below the first quartile (<526.43 mg/day) was associated with a higher risk of short sleep duration in males (1.26; 95%CI: 1.02–1.55) and females (1.19; 95%CI: 1.05–1.34) and with the Athens Insomnia Scale insomnia in males (2.56; 95%CI: 1.36–4.82) and females (1.47; 95%CI: 1.10–2.05). Regarding academic specializations, females in the humanities field showed a higher risk of Athens Insomnia Scale insomnia due to low tryptophan intake (Q1: 3.15; 95% CI: 1.04–9.55 and Q2: 3.41; 95%CI: 1.01–11.5). In summary, lower tryptophan consumption appears to be associated with poorer sleep quality in Spanish university students; however, other social factors affecting students may also influence sleep quality. These findings have important implications for nutritional recommendations aimed at enhancing tryptophan intake to improve sleep quality. Full article