Search Results (1,502)

Background/Objectives: Diabetic neuropathy is a prevalent complication of type 2 diabetes mellitus (T2DM), but the contribution of dietary factors to neuropathy severity remains insufficiently characterized. This study investigated associations between dietary patterns, nutrient intake, and neuropathy severity in 300 adults with T2DM from Northeastern Romania. Methods: Dietary intake was assessed using a validated food frequency questionnaire, and five dietary patterns were derived using principal component analysis. Neuropathy severity was analyzed as an ordinal outcome using logistic regression models adjusted for age, sex, HbA1c, diabetes duration, and treatment. Results: Higher adherence to Western/fast-food and alcohol and animal fat dietary patterns was associated with greater neuropathy severity in unadjusted analyses, whereas a healthy/prudent pattern showed inverse associations; however, these relationships were attenuated after multivariable adjustment. In contrast, higher intakes of protein (OR = 0.98, 95% CI: 0.97–0.99), magnesium (OR = 0.99, 95% CI: 0.98–1.00), zinc (OR = 0.80, 95% CI: 0.69–0.94), vitamin B3 (OR = 0.94, 95% CI: 0.89–0.99), and vitamin B12 (OR = 0.76, 95% CI: 0.62–0.93) remained independently associated with lower neuropathy severity after adjustment. Conclusions: These findings suggest that specific nutrient intakes may be more strongly associated with diabetic neuropathy severity than overall dietary patterns, highlighting potential nutritional targets for neuropathy risk reduction and clinical management in patients with T2DM. Full article

Background: MASLD is characterised by chronic inflammation and oxidative stress, which contribute to disease progression. Currently, no effective pharmacological treatment is available, and the first-line treatment remains lifestyle modification, including dietary changes and physical activity. This study aimed to assess the effect of dietary antioxidants, anthocyanins, on the risk of MASLD in a cohort from Southern Italy. Methods: The sample of this study comprised 1, 297 individuals aged between 54 and 64 years from a larger cohort, the NUTRIHEP study cohort. Data on anthocyanin intake were collected using a food-frequency questionnaire. MASLD is diagnosed when fatty liver disease is present in conjunction with at least one cardiometabolic risk factor. Results: Anthocyanin intake was inversely associated with MASLD risk. In Model b, adjusted for adjusted for age, sex, Fasting Glucose, Triglycerides, Diastolic Blood Pressure, Job, Alcohol consumption (g/day), daily energy intake, adherence to the Relative Mediterranean Diet (rMED), Available Carbohydrates, fibre intake, the third quartile (Q3) and the highest intake group (Q4) of anthocyanins showed a negative correlation with MASLD. Analysis of Anthocyanin intake as a continuous variable showed a modest negative association with MASLD risk (OR = 0.990, 95% CI 0.989–0.999), suggesting that higher anthocyanin intake may slightly lower the risk of MASLD. Conclusions: Our study highlights the protective effects of dietary anthocyanins against MASLD. These findings confirm the potential preventive role of dietary polyphenols in MASLD and identify anthocyanins as novel targets for intervention. Full article

Background: Mental well-being is an important yet often overlooked component of cardiometabolic health. Dietary habits may influence psychological outcomes, but evidence among high-risk populations in Central and Eastern Europe remains limited. This study investigated the association between dietary behaviors and mental well-being among adults with cardiometabolic risk in Hungary. Methods: A cross-sectional analysis was conducted using data from the European Health Interview Survey (EHIS) 2019. The study included 2785 adults with cardiometabolic high risk (obesity, hypertension, or hypercholesterolemia). Mental well-being was assessed using the WHO-5 Well-Being Index and categorized as poor (≤50) or better (>50). Dietary habits, sociodemographic factors, and lifestyle factors were analyzed. Weighted multivariable logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Overall, 25.9% of participants had poor mental health. In multivariable analyses, low intake of vegetables (OR = 1.15), fruits (OR = 1.55), fruit juice (OR = 1.26), and fish (OR = 1.17), as well as inadequate water intake (OR = 1.38), were each independently associated with higher odds of poor mental health after adjustment for sex, education, income levels, self-perceived health status, physical activity, and alcohol consumption. Conclusions: Healthier dietary behaviors, particularly higher consumption of vegetables, fish, and adequate hydration, are associated with better mental well-being among individuals with cardiometabolic risk. These results underscore the need for comprehensive intervention strategies that simultaneously address physical health and psychological well-being among vulnerable populations. Full article

Hepatocellular carcinoma is challenging to detect at an early stage, and its severity increases over time. Recently, the incidence of hepatocellular carcinoma has increased, partly due to lifestyle-related factors such as excessive alcohol intake, sedentary behavior, and diets high in fat, which contribute to the growing prevalence of fatty liver and hepatitis. Various therapeutic strategies are being explored for hepatocellular carcinoma, among which therapies targeting deubiquitinating enzymes (DUBs) have attracted growing attention. Ubiquitination acts as a crucial modulator in the regulation of intracellular signaling across many diseases. E3 ligase recognizes the target protein and transfers ubiquitin, received from the E2 enzyme, to the lysine residues of the substrate, thereby conferring specificity to the ubiquitination process. Once a ubiquitin chain is attached to a target protein by an E3 ligase, the protein is directed to the ubiquitin–proteasome system (UPS) for degradation. In this process, the 26S proteasome complex recognizes the ubiquitin chain and degrades the target protein, thereby serving as a major mechanism for maintaining protein homeostasis. Through this pathway, cells regulate signal transduction, eliminate abnormal proteins, and perform various essential functions. On the other hand, deubiquitinating enzymes (DUBs) recognize the ubiquitin chains on target proteins and remove them by hydrolyzing the isopeptide bonds of ubiquitin, thereby enabling the target proteins to evade degradation by the proteasome system. Furthermore, deubiquitinating enzymes independently remove ubiquitin from proteins and can serve as central regulators in signaling pathways related to hepatocellular carcinoma. Full article

Type 2 diabetes (T2D) is a prevalent disease worldwide that increases the risk of cardiovascular (CV) complications, disability and mortality. While excessive alcohol consumption is harmful, the effects of moderate wine consumption remain debated. This review evaluates whether moderate wine intake affects the risk of developing T2D and its impact on subjects with T2D. Twenty-eight studies were analysed. Evidence suggests an association between moderate wine consumption and the risk of developing T2D, with a J-shaped relationship, and reduced risk observed at low levels. This effect appears more pronounced with red wine, likely related to its higher polyphenol content, and when consumed with meals. On the other side, in patients with T2D, moderate wine consumption has been associated with a reduced risk of CV complications, nephropathy and mortality. It has also been linked to improved lipid profiles and reduced inflammatory markers, without adversely affecting body weight or glycaemic control in well-managed patients. These effects may be enhanced within a Mediterranean dietary pattern, suggesting synergistic actions. However, alcohol intake may increase the risk of hypoglycemia, particularly in patients receiving glucose-lowering therapies. It should be avoided by vulnerable individuals, and those with comorbidities such as MASLD and other significant liver diseases, peripheral neuropathy or other severe conditions. In conclusion, moderate wine consumption may be associated with a reduction in the risk of developing T2D and with several CV benefits in patients with T2D. Vulnerable patients should abstain and individuals who currently do not drink alcohol should not start drinking. If wine is consumed, intake should always remain moderate (as low as possible), within healthy meals and only after individual clinical assessment. Full article

Background/Objectives: Occupation shapes time use, physical demands, stress, and access to health resources, yet it remains an understudied axis of inequality among working women in low- and middle-income countries. This study assessed occupational-group disparities in lifestyle behaviors and adiposity levels among Peruvian working women. Methods: We conducted a pooled repeated cross-sectional analysis of ten Peruvian DHS/ENDES rounds from 2014–2019 and 2021–2024 among working women aged 18–49 years. The exposure was standardized occupational group, using professional/technical/managerial workers as the reference. Outcomes included five lifestyle behaviors and four adiposity indicators. Crude models estimated descriptive prevalence ratios (PRs) or beta coefficients; secondary adjusted models included age group, survey year, education, wealth, residence, natural region, and marital status. Results: A total of 40,726 women were included. Agricultural workers showed lower crude prevalences of almost-daily television viewing (PR 0.49; 95% CI 0.47–0.52), current smoking (PR 0.14; 95% CI 0.10–0.19), current alcohol use (PR 0.39; 95% CI 0.36–0.42), and heavy alcohol use (PR 0.17; 95% CI 0.12–0.27); these contrasts attenuated but generally persisted after adjustment. Insufficient fruit and vegetable intake exceeded 87% in all groups. Sales, domestic/household, services, and skilled manual workers had higher adjusted obesity than the reference group, with adjusted PRs ranging from 1.22 to 1.35. Conclusions: Occupation identifies relevant heterogeneity in lifestyle behaviors and adiposity levels among Peruvian working women. Lifestyle and adiposity profiles did not follow a simple social gradient, supporting occupation-specific strategies for noncommunicable disease prevention. Full article

Background/Objectives: There has been a growing concern about excessive caffeine consumption among heavy green tea drinkers on health outcomes, such as cardiovascular diseases or cancer. We evaluated the association between green tea consumption and risk of all-cause mortality in Vietnam. Methods: We used data from the Hanoi Prospective Cohort Study, an ongoing study comprising 42,146 participants aged 10 or older in Northern Vietnam who have been followed up between 2007 and 2019. Green tea intake was derived from a validated semi-quantitative food frequency questionnaire. We performed a Cox proportional hazard regression model to calculate the hazard ratio (HR) and respective 95% confidence intervals (95% CIs) for the association between green tea consumption and risk of all-cause mortality, adjusted for potential confounding factor. Results: After a median follow-up of 11 years (range: 0.13–11.64 years), we identified 2494 deaths. Overall, there was an inverse association between green tea intake and risk of all-cause mortality (HR_{perSDincrement} = 0.93; 95% CI, 0.89–0.97, P_trend < 0.001). This pattern was more pronounced in males (HR_{perSDincrement} = 0.93; 95% CI, 0.89–0.97, P_trend < 0.001) but not in females (HR_{perSDincrement} = 0.94; 95% CI, 0.86–1.02, P_trend = 0.12; P_{heterogeneity} = 0.81). In stratified analysis, the inverse association pattern was seen in both younger and old age groups, in individuals with BMI < 23 kg/m², in both ever and never smokers, among ever alcohol drinkers and never coffee drinkers, and in individuals with and without history of type 2 diabetes (P_{heterogeneity} = 0.31). Conclusions: Findings from the current study, the first prospective cohort study in Vietnam, suggest a protective effect of green tea consumption on risk of all-cause mortality. Further studies are warranted to validate our findings in similar population and settings. Full article

Objective: The aim of this study was to evaluate associations between flavonoid intake at dinner versus breakfast and the odds of non-alcoholic fatty liver disease (NAFLD) using data from the National Health and Nutrition Examination Survey (NHANES). Methods: According to total flavonoids, flavonoids intake at breakfast and dinner, or flavonoids intake differences at dinner and breakfast (Δ = dinner-breakfast), we divided 3240 participants from the NHANES (2007–2010) into five groups. Logistic regression analyses were performed to examine associations between total flavonoids, flavonoid intake at breakfast and dinner or Δ flavonoids and NAFLD after the adjustment of several confounding factors. Dietary substitution models were used to estimate the association between replacing 5% of flavonoid intake at dinner with that at breakfast and the odds of NAFLD. Results: For total flavonoids intake and flavonoids intake at breakfast, when compared to the lowest quintile (Q1), participants in the highest quintile of total flavonoids intake had lower odds of NAFLD, with an adjusted odds ratio (OR) for NAFLD of 0.78 (95% confidence interval (CI): 0.61–0.98) and a p-trend of 0.076. Participants in the highest quintile of flavonoid intake at breakfast had an adjusted OR for NAFLD of 0.87 (95% CI: 0.69–1.09) and a p-trend of 0.035, also showing a trend toward lower odds of NAFLD. Conversely, for Δ flavonoids, participants in the highest quintile had higher odds of NAFLD, with an adjusted OR for NAFLD of 1.27 (95% CI: 1.01–1.60) and a p-trend of 0.093. When total flavonoid intake in participants remained constant, replacing 5% of dietary flavonoid intake at dinner with that at breakfast was associated with 7% lower odds of NAFLD. Conclusions: Higher flavonoid intake at breakfast than at dinner may be associated with lower odds of NAFLD. Future research should focus on the potential role of breakfast-timed flavonoid intake in preventing the onset of NAFLD. Full article

Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer and one of the leading causes of cancer-related mortality globally, with its incidence increasingly driven not only by viral hepatitis and alcohol-related etiologies but also by metabolic dysfunction-associated steatotic liver disease. Dietary intake can modify gut microbial activity and the production of microbial metabolites, which in turn may regulate hepatic immune signaling and metabolic pathways along the gut–liver axis. Microbiota-derived metabolites have emerged as important immunometabolic mediators linking dietary factors to hepatic immune responses and metabolic reprogramming. These metabolites, which have been shown to influence hepatic immune cell function and inflammatory signaling, include short-chain fatty acids, secondary bile acids, and tryptophan-derived indoles. Changes in the production and composition of these metabolites have been associated with immune dysregulation, chronic inflammation, and metabolic reprogramming that promote hepatocellular carcinoma development. This review highlights how diet–microbiota interactions reshape hepatic immunometabolism and discusses their potential translational relevance for prevention and therapeutic strategies in hepatocellular carcinoma. Full article

Background/Objectives: This study aims to estimate the prevalence of MASLD in a general outpatient population, describe associated metabolic risk factors, and evaluate liver fibrosis. Methods: We conducted a prospective, cross-sectional study at a tertiary hospital that included adults referred there for abdominal ultrasound for non-hepatic indications. Exclusion criteria were significant alcohol intake or known liver disease. Hepatic steatosis was assessed by ultrasound in all patients, and vibration-controlled transient elastography (VCTE) was performed in a subgroup. Clinical and laboratory data were collected. Comparisons used the chi-square test, Fisher’s exact test, and the Wilcoxon test, and logistic regression identified associated factors. Results: Hepatic steatosis was identified by ultrasound in 57.6% of the 182 patients, with most (93%) fulfilling the MASLD criteria. MASLD was diagnosed in 58.2% of patients based on ultrasound or VCTE findings of steatosis. Hepatic steatosis by ultrasound was associated with higher BMI (OR 1.30; 95% CI 1.18–1.43), hypertension (OR 1.92; 95% CI 1.04–3.53), glucose disorders (OR 3.33; 95% CI 1.60–6.92), and triglycerides (OR 1.01; 95% CI 1.00–1.03), while physical activity was protective (OR 0.86; 95% CI 0.26–0.99). Among 74 patients evaluated by VCTE, 8% had fibrosis (≥F1), which was more frequent in those with higher BMI and a number of cardiometabolic risk factors. Conclusions: This study reveals a high prevalence of MASLD and fibrosis among outpatients, supporting the use of abdominal ultrasound for opportunistic screening of MASLD and emphasizing the need for early risk stratification and referral. Full article

Background/Objectives: The roles of healthy lifestyle and socioeconomic status (SES) in prevalent hypertension, as well as their joint patterns, remain incompletely understood. This study examined the independent, interactive, and joint associations of multidimensional SES and multiple healthy behaviors with prevalent hypertension. Methods: We conducted a cross-sectional analysis of baseline data from 80,218 adults enrolled in the Regional Ethnic Cohort Study in Northwest China between 2017 and 2019. The mean age of the participants was 53.9 years. SES was classified as high, middle, or low according to household per capita income, occupation, and educational attainment. Healthy lifestyle was assessed using five factors: non-smoking, moderate alcohol intake, regular physical activity, adequate coarse-grain intake, and healthy sleep patterns. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of SES and healthy behaviors with prevalent hypertension. Results: Hypertension prevalence was higher in the low-SES group than in the high-SES group (45.1% vs. 28.8%). Each additional healthy behavior was associated with 16% lower odds of hypertension (OR: 0.84; 95% CI: 0.82–0.86). Within each SES stratum, participants with 0–1 healthy behaviors had the highest odds of hypertension compared with those with 4–5 healthy behaviors (high SES: OR = 1.58, 1.31–1.92; middle SES: OR = 1.62, 1.39–1.89; low SES: OR = 1.58, 1.22–2.05). A similar but weaker pattern was observed among those with 2–3 healthy behaviors (ORs ranging from 1.18 to 1.32). Among participants with 4–5 healthy behaviors, the odds of prevalent hypertension increased as SES decreased (middle SES: OR = 1.06, 95% CI: 0.97–1.16; low SES: OR = 1.29, 95% CI: 1.17–1.42; reference: high SES). This gradient was more pronounced among those with 2–3 healthy behaviors (ORs ranging from 1.24 to 1.55). Conclusions: Both socioeconomic disadvantage and unhealthy lifestyle were associated with higher odds of prevalent hypertension. Although adherence to a healthy lifestyle was associated with lower odds of prevalent hypertension, it did not fully attenuate the excess odds associated with socioeconomic disadvantage. Full article

Introduction: Dietary habits adopted during young adulthood play a critical role in physical, emotional, and cognitive health. University students represent a particularly vulnerable group due to academic stress, lifestyle transitions, and increased autonomy, factors that may influence eating behaviors, body weight perception, and psychological well-being. This study aims to examine dietary habits among students and their associations with self-perceived body weight, lifestyle characteristics, and psychological factors within a biopsychosocial framework. Materials and Methods: A cross-sectional observational study was conducted using a structured, self-administered online questionnaire distributed to university students aged 18–30 years in Romania. The questionnaire assessed dietary habits, nutritional knowledge, lifestyle behaviors, and psychological variables, including perceived stress and body weight perception. Body mass index was calculated based on self-reported anthropometric data. Results: The findings indicated substantial variability in dietary behaviors, with a high prevalence of irregular meal patterns, frequent snacking, and engagement in weight-control practices. Irregular meal patterns were reported by approximately 62% of participants, while 47% had engaged in at least one weight-loss diet. Discrepancies between self-reported BMI and perceived body weight were observed in roughly 38% of cases, and 83% of respondents reported at least one psychological symptom (stress, anxiety, or low mood) related to eating behaviors. A positive correlation was observed between sleep duration and perceived rest quality (r = 0.364, p < 0.001). High frequencies of caffeinated beverage consumption were also observed. Additionally, 204 participants reported no alcohol consumption, while the variety of alcoholic beverages consumed was strongly correlated with alcohol intake frequency (r = 0.734, p < 0.001). Conclusions: Dietary habits among university students are closely interconnected with body weight perception, lifestyle behaviors, and psychological well-being. These findings emphasize the need for integrative health promotion strategies that address nutrition, emotional regulation, and lifestyle balance to support mental and cognitive health during young adulthood. Full article

Background: Fibromyalgia is a chronic pain disorder. Patients often introduce lifestyle changes, including dietary modifications and physical activity, after diagnosis to alleviate symptoms. However, real-world patterns of these post-diagnostic adaptations remain poorly understood. Methods: An exploratory cross-sectional study was conducted in 88 patients with fibromyalgia using a study-specific questionnaire. Spearman correlation and network analysis were applied to assess relationships between lifestyle changes. K-means clustering was used to identify adaptation patterns. Differences in symptom severity were evaluated using the Kruskal–Wallis test and regression analysis. Results: Participants most frequently increased vegetable and water intake and reduced consumption of meat, alcohol, and sugar-sweetened beverages. Network analysis revealed structured co-occurrence patterns among dietary changes. Three clusters were identified: minimal (n = 47), selective (n = 27), and comprehensive (n = 14). No significant association was found between adaptation patterns and symptom severity (p = 0.53). Conclusions: Patients with fibromyalgia may adopt structured, non-random lifestyle changes following diagnosis. These findings provide a data-driven perspective on real-world behavioral adaptation patterns and highlight the need for longitudinal research to better understand their potential role in disease management. Full article

Background: Alcohol-related macrocytic anemia remains insufficiently characterized, particularly regarding molecular correlates of disease severity and treatment response. We evaluated the hepatic, inflammatory and microRNA profile of patients with alcohol-related macrocytic anemia and explored predictors of hematologic improvement. Methods: This prospective single-center observational study included 60 adults with alcohol-related macrocytic anemia. Patients were stratified by baseline severity (mild, n = 21; moderate, n = 17; severe, n = 22) and by treatment response (no change, n = 18; improved, n = 42). Hematologic, iron, nutritional, inflammatory, hepatic and miRNA (miR-21, miR-34a, miR-451a) data were analyzed using non-parametric tests, Spearman correlations and exploratory logistic regression. Results: Greater anemia severity was associated with longer alcohol exposure, higher weekly alcohol intake, higher GGT, more frequent chronic liver disease and higher expression of all three miRNAs. Hemoglobin and hematocrit decreased across severity groups, whereas MCV increased. Vitamin B12, folate, iron indices, CRP and IL-6 did not differ significantly by severity. No variable significantly distinguished patients who improved from those without hematologic change. All three miRNAs correlated inversely with hemoglobin and positively with MCV, GGT and alcohol-consumption measures. Conclusions: Alcohol-related macrocytic anemia shows a severity gradient linked to alcohol burden, hepatic involvement and distinct miRNA dysregulation. Predictors of treatment response were weak, supporting larger validation studies. Full article

Background/Objectives: Physical activity is a cornerstone of preventive health, yet its practice often coexists with the consumption of alcoholic beverages like beer and wine. While these beverages contain bioactive compounds with potential health properties, alcohol itself carries significant risks. This systematic review aimed to synthesize and critically assess the evidence on physical activity and beer and wine consumption. Specifically, we examined their combined effects on metabolic syndrome components (body composition, blood pressure, lipids, glucose metabolism); inflammation and oxidative stress markers; mental health outcomes (cognitive function, mood, sleep); and physical performance, neuromuscular recovery, and fluid balance. Methods: Following a pre-registered protocol (PROSPERO: CRD420261281945), a systematic search of PubMed/MEDLINE, Scopus, and SPORTDiscus was conducted for studies published between 2000 and 2025. Included studies were randomized controlled trials or observational studies involving physically active adults (aged ≥ 18 years) who consumed beer or wine. Studies focusing solely on sedentary populations were excluded. Outcomes assessed included metabolic syndrome components, inflammation, oxidative stress, mental health, cognitive function, and physical performance. Risk of bias was evaluated using Cochrane RoB 2 for RCTs and ROBINS-I for non-randomized studies. Results: Eight studies were included. Moderate beer or wine consumption did not substantially negate the beneficial effects of exercise on cardiometabolic health, body composition, or cognitive function. Higher alcohol intake was associated with elevated blood pressure. Acute post-exercise consumption of alcoholic beer impaired rehydration and neuromuscular recovery, whereas non-alcoholic beer did not. Conclusions: Given the small number of studies and risk of bias, these findings should be interpreted with caution. In physically active populations, moderate beer or wine consumption does not clearly undermine the benefits of regular exercise on metabolic syndrome components (body composition, blood pressure, lipids, glucose metabolism). No additional benefits on inflammation or oxidative stress were observed, nor on mental health outcomes (cognitive function, mood, or sleep). However, acute post-exercise alcohol intake impairs rehydration and neuromuscular recovery, whereas non-alcoholic beer represents a safer alternative. Full article