Search Results (1,868)

Background/Objectives: Milk and milk-based beverages have shown potential benefits for maintaining exercise-induced negative energy balance. However, this has not been systematically investigated. Therefore, this review aimed to evaluate the effects of post-exercise milk or milk-based beverages consumption on appetite regulation and energy intake. Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, the Cochrane Library, Ovid MEDLINE ALL, Open Access Theses and Dissertations, and EBSCO Open Dissertations up to 6 April 2025. Eligible studies were randomized controlled trials assessing the effects of milk or milk-based beverages on post-exercise appetite regulation in healthy adults. Study selection, data extraction, and risk of bias assessment (RoB-2) were performed independently by two reviewers. Meta-analysis was conducted where appropriate using mean differences with 95% confidence intervals (CI). Subgroup analyses were conducted by sex and intervention. Results: Twelve studies (n = 140) were included, of which 10 (n = 118) contributed to the meta-analysis of energy intake. Milk and milk-based beverages were associated with lower energy intake than carbohydrate (CHO) beverages (−72.73 kcal, 95% CI [−141.69; −3.77]; I² = 0%, p = 0.039). Subgroup analyses indicated no effect modification by sex or intervention type. For subjective appetite ratings (11 studies, n = 125), meta-analysis was not performed due to measurement and reporting heterogeneity, and no clear differences or only mild appetite-suppressive effects were observed. Appetite-related hormones were assessed in two studies (n = 23), with no overlapping outcomes. Conclusions: Post-exercise consumption of milk and milk-based beverages may reduce energy intake compared with CHO beverages, although effects on subjective appetite are inconsistent and evidence for hormonal responses remains limited. Full article

Background/Objectives: Understanding nutrient intake and diet quality in older adults is essential for promoting healthy ageing and quality of life. The aim of the study was to assess dietary intake and nutritional status in two age groups of older adults in Croatia (65–74 years and ≥75 years). Methods: A total of 786 participants aged 65 and older were included in this cross-sectional study. Data from the National food consumption survey (OC/EFSA/DATA/2017/01), based on the EU Menu methodology, were used. Data collection included a general questionnaire, the International Physical Activity Questionnaire, two 24-h recalls or food diaries, and anthropometric measurements. The effects of body mass index and physical activity level on dietary intake were analysed using a general linear model. Results: 21.5% of older adults in Croatia had a normal weight, while 78.5% of were classified as overweight or obese. Significant differences were recorded in energy and macronutrient intake between the two age groups. Body mass index was significantly associated with energy (kcal/day), fat intake (g/day), and intake of the meat, poultry, fish and eggs food group in the 65–74 year age group. In the ≥75 year age group, physical activity level showed an effect on energy, carbohydrates, and milk and dairy product intake. Intake of nutrient-dense foods and fluids was below recommendations in both observed groups. Conclusions: The study results, based on a representative sample, provide the first overview of the nutritional status of older adults in Croatia. These findings offer a foundation for public health initiatives and further research on the nutritional status of the older population in Croatia. Full article

Background: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition with psychosocial impact. Dietary carbohydrates, particularly added sugars, refined starches, and high-glycemic index/load (GI/GL) patterns, have been proposed as modifiable exposures that may relate to attention and behavioral regulation. This systematic review synthesized evidence linking carbohydrate quantity and quality to ADHD-related outcomes. Methods: Following PRISMA 2020, PubMed, Scopus, and Web of Science were searched for English-language studies published from January 2015 to December 2025. Eligible studies included observational and interventional designs in children, adolescents, or adults with a clinical ADHD diagnosis or validated symptom assessment. Risk of bias was assessed using NOS/NOS-adapted criteria, RoB 2, and ROBINS-I. Findings were synthesized narratively by exposure domain. Results: Of 1174 records identified, 48 studies were included: 38 observational and 10 interventional. Sugar-related exposures showed the most consistent pattern: 15 of 16 studies examining added sugars, sugar-sweetened beverages, sweets, candy, or sweet dietary patterns reported positive associations with ADHD diagnosis, symptom severity, hyperactivity, or less favorable ADHD-related outcomes. Findings for total carbohydrate intake were inconsistent. GI/GL-specific evidence was limited but generally adverse in direction. Among intervention studies, symptom improvement after modification was reported in 6 of 10 studies, whereas 4 studies showed mixed, preliminary, non-significant, or non-superior findings. Most observational studies showed moderate to high risk of bias, while interventional studies showed variable risk across domains. Conclusions: Poorer carbohydrate quality may be associated with greater ADHD-related symptom burden, whereas total carbohydrate intake showed inconsistent associations. Certainty remains limited by heterogeneity, residual confounding, risk of bias, and limited carbohydrate-specific intervention evidence. Full article

Background: Prostate cancer (PCa) is the most commonly diagnosed malignancy in men and a leading cause of cancer-related mortality worldwide. Growing evidence indicates that metabolic syndrome components, including obesity, insulin resistance, and hyperglycemia, contribute to PCa development, and progression to more aggressive form. At the same time, standard treatments such as androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) significantly improve oncologic outcomes but are associated with adverse metabolic effects, including increased fat mass, insulin resistance, and sarcopenia, potentially worsening patients’ overall metabolic profile and quality of life. Tumor progression in PCa is strongly driven by androgen receptor (AR) signaling, which is closely linked to cellular metabolic reprogramming, highlighting metabolism as a potential therapeutic target. Aim: The aim of this study was to evaluate and synthesize current evidence on the role of the ketogenic diet (KD) in PCa, with particular emphasis on its interaction with hormonal therapies, underlying metabolic and endocrine mechanisms, and its potential application as an adjunctive strategy in integrated oncologic care. Results: The KD, characterized by high fat and very low carbohydrate intake, induces a metabolic state of ketosis that reduces circulating glucose, insulin, and insulin-like growth factor 1 (IGF-1), potentially counteracting metabolic alterations associated with PCa and its treatments. Preclinical studies consistently demonstrate that carbohydrate restriction and KD can slow tumor growth, modulate key oncogenic pathways such as PI3K/AKT/mTOR, reduce systemic insulin signaling, and enhance survival in prostate cancer models. Additionally, emerging evidence suggests possible synergistic effects when KD is combined with standard therapies, including ADT and immunotherapy. Clinical data, although limited, indicate that low-carbohydrate dietary interventions may improve metabolic parameters and could delay biochemical progression, as suggested by increased prostate-specific antigen (PSA) doubling time. However, results across studies remain heterogeneous, and robust evidence on long-term oncologic outcomes is lacking. Conclusions: Overall, the KD represents a promising but still experimental strategy in PCa management, requiring careful nutritional supervision to avoid adverse effects such as unintended weight loss or sarcopenia. Further well-designed randomized clinical trials are needed to clarify its safety, efficacy, and role in routine clinical practice. Full article

Background/Objectives: Diet is considered one of the most important modifiable risk factors for non-communicable diseases in modern society. While numerous studies have reported on the association between diet and mental health, including anxiety, research examining the relationship between dietary patterns and mental health is relatively scarce. Therefore, this study aimed to analyze the association between anxiety and suicidal ideation with macronutrient intake. Methods: This study was conducted on adults aged 19 years or older using raw data from the 2021–2023 Korea National Health and Nutrition Examination Survey. Excluding those with missing test items, 9002 subjects were included. The study subjects were divided into four groups based on macronutrient intake (normal diet group, high-carbohydrate diet group, high-fat diet group, and high-protein diet group; based on Korean Dietary Reference). Results: There was no significant association between dietary patterns and suicidal ideation. However, after adjusting for covariates for moderate or severe anxiety in the HP diet group, the odds ratio was reported to be 0.492 (95% CI 0.298–0.810). Subgroup analysis by gender revealed no significant difference between dietary types and anxiety in women, but in men, the HP diet significantly lowered the odds of moderate or severe anxiety (OR 0.230, 95% CI 0.089–0.599). Conclusions: This study found that higher protein intake was associated with lower levels of moderate to severe anxiety, and this trend was statistically significant, particularly in men. Further research is needed to confirm the causal relationship. Full article

Background/Objectives: University students frequently exhibit suboptimal dietary habits, and even those enrolled in nutrition-related programmes may fail to meet recommended intakes of several key nutrients. This study aimed to assess changes in dietary intake and body composition over a single academic semester among university nutrition students. Methods: A prospective pre–post study was conducted with 102 students at the Czech University of Life Sciences Prague. Dietary intake was assessed using a 3-day food record and evaluated for energy, macronutrients, and specific micronutrients. Body composition was measured by a multi-frequency bioelectrical impedance analysis. Changes between baseline and follow-up were analysed using paired statistical tests with the false discovery rate correction. Predictors of follow-up body fat percentage were examined using an analysis of covariance. Results: At baseline, mean daily energy intake was 2114 ± 632 kcal. A particularly low intake was observed for dietary fibre (15.45 ± 8.46 g/day), potassium (2013 ± 954 mg/day), iodine (63.5 ± 69.8 µg/day), and vitamin D (2.31 ± 3.01 µg/day), whereas protein intake was relatively high. During follow-up, significant increases were observed in the intake of carbohydrates (+54.2 g/day), dietary fibre (+9.3 g/day), potassium (+766 mg/day), vitamin C (+69.2 mg/day), and magnesium (+86.2 mg/day), together with lower sodium and saturated fat intake (all adjusted p < 0.001). No significant short-term changes were found in body weight, body fat percentage, or skeletal muscle mass. Follow-up body fat percentage was primarily associated with baseline adiposity. Conclusions: One semester of nutrition-related education was associated with improved dietary intake, particularly for fibre and selected micronutrients, but not with measurable short-term changes in body composition. These findings suggest that nutrition education may support healthier dietary behaviour and may contribute to preventive healthcare strategies in young adults. Full article

Background: Red ginseng (RG) exhibits enhanced bioactivity compared to white ginseng. Although the beneficial effects of RG have been well investigated in disease models, its impacts on the metabolome, gut microbiota, and immune response under normal physiological conditions remain poorly understood. Methods: Rats were randomized into three groups: control (normal diet), RL (low-dose RGE at 100 mg/kg body weight), and RH (high-dose RGE at 200 mg/kg body weight). After five weeks, metabolite profiles of the blood, liver, kidney, and large intestinal contents were analyzed and the gut microbiota was assessed. Splenocytes were isolated and treated with or without ethanol-precipitated carbohydrate fractions isolated from RGE or from intestinal contents, and IL-12 secretion was measured. Additionally, the correlations among biochemical characteristics, metabolites, gut microbiota, and immune markers were analyzed. Results: RGE intake decreased plasma triglycerides, liver function biomarkers, and epididymal adipose tissue weight. It also altered metabolite profiles for plasma, liver, kidney, and intestinal contents and increased the hepatic NAD⁺/NADH ratio. RGE intake reduced the populations of harmful bacteria, whereas it increased Lachnospiraceae. RGE intake enhanced IL-12 production in splenocytes. Furthermore, splenocytes treated with carbohydrates isolated from the small and large intestinal contents of RGE-fed rats secreted higher IL-12 levels than those of the control group. Conclusions: RGE modulated the gut microbiota, metabolism, and immune responses in healthy rats under normal physiological conditions, warranting further investigation into the underlying mechanisms. Full article

Obesity is currently recognized as a chronic and multifactorial disease. According to epidemiological data released by the World Health Organization in 2022, more than 2.5 billion adults were overweight and more than 890 million were affected by obesity. The aim of this narrative review is to clarify what leads to overweight and obesity, to explain the concept of energy balance, to address the limited effectiveness of dietary products marketed for weight reduction, to examine commonly promoted nutritional strategies for weight loss and to challenge claims of their superiority. The most recent, robust, and high-quality evidence available on the topic was selected, with particular emphasis on systematic reviews and meta-analyses. Overweight and obesity are characterized by an excessive accumulation of fat mass. At the basis of excessive adipose tissue accumulation lies a persistent positive energy balance. Energy balance is generally considered a central physiological determinant of body weight regulation. Approaches that do not explicitly incorporate this principle may be associated with variable or unsustained outcomes. Available evidence suggests that, when an equivalent caloric deficit is achieved, differences in the timing of energy intake or in dietary patterns—such as intermittent fasting or low-carbohydrate diets—are not consistently associated with greater weight loss compared with other guideline-based dietary strategies. Some supplements supporting weight loss, in selected cases, may offer marginal support; however, based on the current state of scientific knowledge, no product represents an effective shortcut for weight loss. Full article

Type 1 diabetes mellitus (T1DM) is a chronic, non-preventable, and incurable disease that requires lifelong insulin administration. The principal challenge is calculating the prandial insulin bolus to avoid hypoglycemia and hyperglycemia. Traditional bolus calculators are based on limited number of variables, but there are many variables that define the complex interactions among glucose levels, like carbohydrate intake, physical activity, mood, and contextual factors. While recent artificial intelligence (AI) approaches have shown promise in glucose prediction, most remain correlational and offer limited interpretability for clinical decision support. This study evaluates a causal inference-based framework for insulin bolus calculation using Directed Acyclic Graphs (DAGs) and the Greedy Relaxation of the Sparsest Permutation (GRaSP). Historical data from individuals with T1DM were analyzed, incorporating domain knowledge constraints to guide structure learning. A bootstrap-based stability analysis was conducted to evaluate the robustness of inferred relationships. Results show that integrating prior medical knowledge reduces graph complexity and improves interpretability. However, bootstrap stability reflects robustness of the learning procedure rather than causal validity. The findings suggest that the proposed framework is useful for generating plausible causal hypotheses, but not for confirming causal relationships. Further validation using conditional independence testing, equivalence class analysis, and temporal causal methods is required. However, the proposed framework focuses on generating plausible causal hypotheses rather than establishing causal validity, which requires further refutation-based validation. Full article

Background: School meals are crucial for children’s development and can contribute to the prevention, amongst others, of obesity and type 2 diabetes mellitus. We analyzed the conformity of meal composition with the quality standard for meals in schools (QST) of the German Nutrition Society (DGE) and reference values for nutrient intake of the nutrition societies of Germany and Austria (DGE/ÖGE) in Thuringian schools. Methods: Components of the school meals (portions in primary and secondary schools) were collected at two timepoints (T1 and T2). The contents of selected nutrients (protein, carbohydrates, fat, fatty acids, dietary fiber, vitamins, minerals) were analyzed and tested for alignment with the aforementioned adapted reference values. Results: More than half of the school meals examined were ovo-lacto-vegetarian meals (T1: 64%; T2: 63%). The energy content of macronutrients and the contents of vitamins B₁ and E, folate, calcium, iron and magnesium covered the requirements of the DGE/ÖGE reference values. Good n-6/n-3 PUFA ratios between 2.6 and 4.1 were found. In contrast, vitamin C was not detectable in 88.5% (T1) and 90.6% (T2) of the tested meal components, and sodium references were exceeded by a factor of five to eight. Additionally, the total sugar content of the meals tended to be high, with 85% of all meals exceeding the lower energy limit for free sugars (≥7 to <10 years) and >70% exceeding the upper limit (≥10 to <19 years) set forth by WHO and DGE/ÖGE. Conclusions: In the process of school meal preparation, attention should be paid to the preservation of vitamin C and the economical use of salt and sugar. Full article

Proper nutrition is a fundamental determinant of human health and is structured through the intake of various nutritional components: (i) macronutrients, including carbohydrates, lipids, and proteins, which provide energy and essential structural materials for metabolic and physiological processes; (ii) micronutrients, such as vitamins and minerals, although required in smaller quantities, play crucial roles as enzymatic cofactors and regulators of numerous biochemical pathways; (iii) natural bioactive compounds (NBCs), substances found in plant-based foods (including polyphenols, carotenoids, phytosterols, and sulfur compounds) that exert protective effects thanks to their antioxidant and anti-inflammatory properties, contributing to the prevention of numerous chronic non-communicable diseases (CNCDs) [...] Full article

Background: Post-bariatric hypoglycemia (PBH) is a clinically significant complication of bariatric surgery, characterized by inappropriate postprandial hyperinsulinemia and recurrent hypoglycemia. Episodes are often frequent, severe, and medically refractory, substantially impacting quality of life and potentially causing compensatory carbohydrate intake that leads to weight regain. Methods: A 50-year-old male underwent Roux-en-Y gastric bypass (RYGB) in 2009. Symptomatic postprandial hypoglycemia emerged in the second postoperative year and progressively worsened to multiple severe daily episodes. The patient developed compensatory carbohydrate intake with subsequent weight regain. Following the failure of dietary interventions and pharmacologic therapy, he underwent conversion to single-anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S) in September 2022. Results: Following surgical conversion, the patient reported no clinically significant hypoglycemia during the follow-up period. Weight and obesity-related comorbidities improved. Gastrointestinal symptoms remained manageable, and micronutrient status was closely monitored. Conclusions: In selected patients with severe, medically refractory PBH following RYGB, conversion to an ileal-based procedure may be considered a viable therapeutic strategy. Prospective studies are needed to better define this hypothesis. Full article

Background: Children and adults with Trisomy 21 are more likely to develop nutrition-related conditions and diseases. The nutrition-related health of Canadians with Trisomy 21 is unknown. We aimed to determine the nutrient intake and physical activity of school-aged children with Trisomy 21 in Manitoba, Canada. Methods: Mothers of 14 school-aged children (n = 7 female, average age 9 years old) with Trisomy 21 completed a 24 h dietary recall and a survey that included questions about their children’s nutrition and physical activity. Nutrient intake analysis was conducted to compare food and beverage consumption with dietary guidelines and nutrient recommendations. Data were analyzed descriptively. Results: Most children with T21 included in this study consumed an adequate average intake of daily protein, carbohydrate, and iron; an inadequate average intake of daily dietary fibre and calcium; and an excessive average daily intake of added sugars and saturated fat. Notably, all children consumed inadequate vitamin D and excessive sodium. Most children consumed a dietary supplement (10/14), engaged in moderate-intensity physical activity (10/14), and were active for more than 60 min per day (12/14). Conclusions: Most children with Trisomy 21 included in this study met daily physical activity recommendations. However, despite a variety of foods reportedly consumed across all food groups, nutrient intake among school-aged children with Trisomy 21 included in this study was mixed, as both deficiencies and excessive amounts of some nutrients were observed. There is a need to improve the nutrient intake of children with Trisomy 21 to reduce their risk of developing nutrition-related conditions and diseases. Full article

Background: Arterial stiffness (AS) is a key marker of vascular aging and an independent predictor of cardiovascular risk. Although diet has been proposed as an important modifiable factor influencing vascular health, the independent associations between specific macronutrients and minerals and the progression of arterial stiffness remain insufficiently characterized. Objective: The aim of this longitudinal study was to evaluate the independent associations of baseline dietary macronutrient and mineral intake with the 5-year progression of arterial stiffness (assessed via carotid–femoral pulse wave velocity (cfPWV) and cardio-ankle vascular index (CAVI) in adults without prior cardiovascular disease. Methods: This longitudinal study included 466 participants from the EVA study who were evaluated at baseline and after a five-year follow-up (mean age 55.96 ± 14.15 years; 51.1% women). Arterial stiffness was assessed using cfPWV and CAVI. Dietary intake of macronutrients and minerals was estimated using the EVIDENT smartphone application. Multivariable linear regression models were used to examine the association between nutrient intake and arterial stiffness progression. Model 1 was adjusted for age and sex, and Model 2 was additionally adjusted for lifestyle variables and cardiovascular risk factors. Dietary intake was exclusively documented at baseline using a 3-day dietary record, while arterial stiffness parameters (cfPWV and CAVI) were assessed both at baseline and at the five-year follow-up. Results: Higher dietary fiber intake was independently associated with a lower increment in cfPWV after full adjustment (β = −0.025; 95% CI (confidence interval): −0.046 to −0.005). Alcohol intake showed a positive association with CAVI increment in the fully adjusted model (β = 0.020; 95% CI: 0.006 to 0.034). Iron intake was also independently associated with increased CAVI (β = 0.022; 95% CI: 0.004 to 0.041). Carbohydrate intake showed a small positive association with CAVI, whereas no consistent independent associations were observed for other macronutrients or minerals. Conclusions: In this adult population without previous cardiovascular disease, higher dietary fiber intake was associated with lower progression of central arterial stiffness, whereas alcohol and iron intake showed positive associations with peripheral arterial stiffness. Overall, most nutrients were not independently related to arterial stiffness after comprehensive adjustment. These findings suggest that selected dietary components may contribute modestly to vascular aging. Full article

Background: Risk of malnutrition among patients with Parkinson’s disease (PD) can reach up to 60%, with prevalence rates as high as 24%. Dietary management for PD patients is a promising adjuvant therapy that may improve some motor and non-motor symptoms. However, there is limited information regarding nutrient intake and adherence to recommended dietary requirements in this population in Lithuania. Methods: In this case–control study conducted at Vilnius University Hospital Santaros Klinikos (2023–2025), usual dietary intake was assessed using two non-consecutive 24 h recalls. Intake was compared with Lithuanian Recommended Daily Intake (RDI) values. Associations between nutrient intake and selected non-motor symptoms were analyzed. Results: Fifty-nine patients with PD and 54 controls were included and compared with RDI; patients with PD had lower intakes of dietary fiber (20.63 g/day), vitamin A (627.15 μgRE/day), and vitamin D (3.18 μg/day), alongside a higher energy contribution from total sugars (11.31 E%). Less than half met RDI for protein, fat, polyunsaturated fatty acids (PUFA), and monounsaturated fatty acids (MUFA) energy contribution, vitamins E and C, calcium, and zinc. Compared with controls, PD patients consumed more dietary fiber, plant protein, and total carbohydrate and had a higher carbohydrate-derived energy contribution. PD patients with depressive mood consumed fewer carbohydrate, dietary fiber, plant protein, and some vitamins and minerals compared to those without. Conclusions: Patients with PD had higher total sugar-derived energy consumption and lower dietary fiber and vitamin D intake than the RDI. There were differences in dietary intake among PD patients with and without specific non-motor functions. Full article