Search Results (721)

The ever-increasing disparity between lifespan and healthspan represents a challenging global issue, with metabolic dysregulation playing a central role in the initiation and progression of chronic non-communicable diseases (NCDs). This review highlights the importance of maintaining optimal redox homeostasis, with particular emphasis on reduced glutathione (GSH), for preserving metabolic health during aging. GSH participates in several physiological processes, including antioxidant defense, xenobiotic detoxification, redox signaling, and metabolic regulation. Diminished GSH levels are consistently reported in obesity, insulin resistance, type 2 diabetes mellitus, non-alcoholic fatty liver, and cardiovascular diseases. Current evidence from human clinical studies indicates that foods rich in bioactive constituents can enhance GSH levels and stimulate GSH-dependent enzyme activity, with the Nrf2/Are signaling pathway being a central mechanistic link. Fasting may promote adaptive redox responses by inducing mild oxidative stress and activating the same molecular mechanism, although the effects on GSH-related antioxidant mechanisms remain heterogeneous across fasting protocols and study populations. Altogether, the available clinical evidence suggests that these nutritional and lifestyle interventions exhibit more consistent beneficial effects in individuals characterized by increased oxidative burden and underlying metabolic dysfunction. Interindividual differences in GSH responses further underscore the need for targeted, tailor-made approaches that account for genetic, epigenetic, and lifestyle factors. Collectively, targeting GSH homeostasis through nutritional and lifestyle interventions represents a promising strategy for improving metabolic health and may further contribute to healthy aging, positioning redox biology at the forefront of aging research and NCD prevention. Full article

Background/Objectives: Chronic non-communicable diseases remain one of the main public health problems. Increasing multimorbidity and the importance of health literacy (HL) emphasize the need for a comprehensive assessment of health indicators. The aim of this study was to assess the main health indicators of the Lithuanian population and trends in the use of healthcare services and to discuss the relevance of these indicators in the context of HL, based on the links between HL and these indicators described in the scientific literature. Methods: A retrospective longitudinal descriptive study was performed using publicly available Lithuanian population health statistics of 2005–2024. Mortality, morbidity, avoidable hospitalizations, subjective health assessment, and utilization of healthcare services and preventive programs were analyzed using descriptive statistical analysis. HL was not directly measured but was used as a conceptual framework for interpreting the findings. Results: In Lithuania, the highest mortality rate is due to cardiovascular diseases (CVDs) (~50.8%). CVD and infectious diseases also dominate the structure of avoidable hospitalizations, and their rates vary greatly across municipalities, being higher in less urbanized areas. The assessment of the population’s health is improving over time, but gender differences remain in the use of healthcare services and preventive programs. Conclusions: The findings demonstrate a high burden of chronic diseases and regional disparities in healthcare utilization in Lithuania. HL may provide a useful context for interpreting these findings, although it was not directly assessed. Future studies should directly evaluate HL and its association with health indicators in the Lithuanian population. Full article

Background/Objectives: Previous publications have primarily examined the individual roles of nutrients during fetal development. However, growing evidence suggests that one-carbon (1C) metabolism nutrients, including choline and key B vitamins, act synergistically within interconnected metabolic pathways that modulate epigenetic regulation and may have implications for the health of future generations. Methods: This narrative integrative review examined evidence relating to the roles of choline and B vitamins (B1, B2, B6, folate (B9) and B12) in fetal development and offspring health. Peer-reviewed literature was identified through PubMed, Science Direct and Semantic Scholar. Results: Current evidence indicates that periconceptional and maternal intake and status of 1C metabolism nutrients are associated with DNA methylation processes involved in developmental programming and the risk of non-communicable diseases (NCDs) in childhood and adulthood. Habitual intakes of several 1C metabolism nutrients are frequently below recommended levels during pregnancy and lactation, particularly for choline and folate. Inadequate intakes, each contributing differently to 1C metabolism, may disrupt 1C metabolic pathways and alter DNA methylation patterns during critical windows of fetal programming. Homocysteine metabolism is intricately linked to 1C metabolism and is modulated by choline and B vitamins. Collectively, these pathways have potential implications for the health of the next generation, including effects on growth, neural tube closure, brain development and increased susceptibility to diseases later in life, e.g., cardiovascular disease, diabetes, obesity and other chronic conditions. Adequate maternal intakes of choline and B vitamins may help mitigate the ‘early life origin’ of certain NCDs by promoting healthy neurodevelopment, reducing inflammation, and regulating central metabolic pathways. Conclusions: Greater awareness of the roles and importance of 1C metabolism nutrients, including choline and key B vitamins (B1, B2, B6, folate and B12), during the early life course is warranted. Furthermore, there is also a need for organizations and policy makers to formalize intake recommendations for 1C metabolism nutrients beyond the individualized simplicity of folate/folic acid, and to extend this to include other methyl-donor nutrients with epigenetic effects, such as choline and key B vitamins, given their interconnected roles in 1C metabolism and fetal development. Full article

Brunei Darussalam has undergone a rapid demographic and epidemiological transition characterized by declining fertility, increased life expectancy, and a shift from infectious diseases to chronic non-communicable conditions. While these transitions are well described at the population level, their implications for family support systems are less explored. This study synthesizes national data to examine how changes in population structure and disease burden are reshaping caregiving and intergenerational support. Findings highlight shrinking family size, increasing dependency, and growing care complexity. Applying the welfare diamond framework, the analysis shows that these transitions are progressively shifting care responsibilities beyond the traditional family towards greater roles for the state, market and community sectors. These findings suggest that Brunei Darussalam is undergoing an emerging care transition that has important implications for long-term care policy. Full article

Background: 4-Hydroxyproline, a product of collagen turnover generated through prolyl hydroxylation, has been implicated in metabolic regulation. While previous studies have associated circulating proline with diabetes, the relationship between 4-hydroxyproline and diabetes remains unclear. Methods: We conducted a cross-sectional analysis of 796 adults aged 35–74 years from Changshu, eastern China. Plasma 4-hydroxyproline levels were quantified using ultra-high-performance liquid chromatography–tandem mass spectrometry. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Higher plasma 4-hydroxyproline levels were associated with increased odds of diabetes after multivariable adjustment (per SD increase: OR = 1.35, 95% CI: 1.10–1.66; p = 0.004). Participants in the highest quartile had higher odds of diabetes than those in the lowest quartile (Q4 vs. Q1: OR = 1.86, 95% CI: 1.01–3.47; p for trend = 0.006). The associations remained materially unchanged after excluding insulin users, individuals with diabetes-related complications, and those using antidiabetic medication. Further adjustment for dietary intake and proline did not materially alter the results. Conclusions: Higher plasma 4-hydroxyproline levels were associated with diabetes. Given the cross-sectional design, causality cannot be inferred, and reverse causation cannot be excluded. Prospective studies are needed to confirm these findings. Full article

Background: According to well-known dietary recommendations, herbs and spices are part of a healthy, balanced diet, and their consumption may contribute to improved health. Globalisation fosters greater exposure to other cultures and cuisines, including the use of spices. This study aimed to assess the awareness and attitudes towards spices among Polish students in a rural area. Methods: A survey study was conducted among 278 Generation Z students (aged 18–28 years old) from a university located in a small town in southeastern Poland. Questions concerning, a.o., preparing meals, awareness of spices’ properties, and the use of seasoning were included. Results: Most of the respondents declared using a lot of spices beyond salt and pepper (61.2%), more often women than men (67.9% vs. 45.1%; p = 0.0004), and more often participants aged ≥23 years than ≤22 years (82.9% vs. 58.0%; p = 0.005). Participants who grew their own spices and often watched TV culinary programs used more seasonings (72.4%; p = 0.001 and 85.2%; p = 0.0002, respectively). Less than half of the respondents (45%) recognised health properties in some of the spices, and 28.1% of them recognised health properties in spices in general, with more older participants (45.7%; p = 0.0402). Respondents with the highest awareness of the health properties of spices used them more often to improve their health (42.3%; p < 0.00). Conclusions: Exposure to cuisines from other cultures and their spices and the willingness to try new flavours among respondents were low. This might be due to sociodemographic factors, including origin from small, rural, traditional communities, where attachment to familiar recipes might be observed. Moreover, awareness of the healing benefits of spice use was low. Therefore, education about the composition and use of local spices might be helpful in increasing their intake for the benefit of health. Full article

Background/Objectives: People with diabetes are more susceptible to viral respiratory infections and worse clinical outcomes related to COVID-19 and influenza. Vaccination is considered an important prevention strategy. This study aimed to analyze the vaccination status against COVID-19 and influenza among people with diabetes mellitus and associated factors. Methods: An analytical cross-sectional study was conducted between May 2024 and May 2025 in 42 Primary Health Care Units in a municipality in Minas Gerais, Brazil. A total of 316 individuals with type 1 or type 2 diabetes mellitus participated in the study. Data were collected using a structured instrument containing socioeconomic, cultural, behavioral, and clinical variables, in addition to verification of vaccination records through physical vaccination cards and information systems. Descriptive analyses and logistic regression models were performed to estimate crude and adjusted odds ratios, with respective 95% confidence intervals. Analyses were performed using Statistical Package for the Social Sciences and Stata. Results: Adherence to COVID-19 vaccination was 21.5%, whereas influenza vaccination adherence reached 85.4%. In the multivariable analysis of COVID-19 vaccination status, previous influenza vaccination (OR = 7.74; 95% CI: 1.81–33.2) and alcohol consumption (OR = 2.11; 95% CI: 1.13–3.89) were positively associated with vaccination. Conversely, access to social media or other communication channels (OR = 0.47; 95% CI: 0.24–0.92) and insulin use (OR = 0.42; 95% CI: 0.21–0.84) were associated with lower odds of COVID-19 vaccination. Regarding influenza vaccination, positive associations were identified for religious affiliation (OR = 6.46; 95% CI: 1.79–23.30), previous COVID-19 vaccination (OR = 10.2; 95% CI: 2.22–47.06), and longer duration of diabetes diagnosis (OR = 3.47; 95% CI: 1.32–9.20). In contrast, alcohol consumption (OR = 0.42; 95% CI: 0.21–0.86), insulin use (OR = 0.35; 95% CI: 0.16–0.76), and absence of medical follow-up (OR = 0.34; 95% CI: 0.13–0.85) were associated with lower odds of influenza vaccination. Conclusions: The findings revealed a heterogeneous vaccination pattern among individuals with diabetes mellitus, in which higher influenza vaccination coverage contrasted with low adherence to COVID-19 vaccination, reflecting not only differences in the historical consolidation of immunization strategies but also contemporary dynamics related to risk perception, trust, and information circulation. The strong association with previous vaccination history suggests that vaccine adherence is part of a continuum of preventive behaviors mediated by the relationship with healthcare services and by the internalization of healthcare practices over time. Full article

Background: Near-infrared spectroscopy (NIRS)-based wearable devices offer non-invasive, continuous monitoring of muscle oxygenation, providing direct microvascular and metabolic information that complements indirect indices of intensity such as heart rate and accelerometry. Their clinical applicability in chronic non-communicable diseases (NCDs) remains under active development. Methods: A structured narrative review was conducted in PubMed, Scopus, Web of Science, and IEEE Xplore (January 2010–January 2026) using pre-specified search strings combining NIRS, muscle oxygenation, SmO₂, StO₂, wearable, exercise intensity, ventilatory/lactate threshold, and individual chronic disease terms. Eligible studies addressed technical validation of wearable NIRS, NIRS-derived exercise intensity estimation, clinical applications in NCDs, or rehabilitation implementation. Evidence was synthesized thematically; quality of validation studies was appraised against AMSTAR-2-informed, COSMIN-informed, or Cochrane RoB-2 criteria. Results: Wearable continuous-wave NIRS shows acceptable concurrent validity with frequency-domain laboratory systems (r = 0.79; range 0.69–0.88; ±8% SmO₂ agreement in 95% of measurements) and good test–retest reliability for moderate-to-severe domains (ICC 0.72–0.91). NIRS-derived breakpoints align more reliably with the second ventilatory/lactate threshold (ICC = 0.80) than with the first (ICC = 0.53), constraining its use for prescribing lower-intensity domains. In chronic obstructive pulmonary disease, peripheral arterial disease, chronic respiratory failure and selected cardiovascular conditions, wearable NIRS detects disease-specific patterns of muscle deoxygenation and post-exercise reoxygenation that track responses to rehabilitation. Conclusions: Current evidence supports wearable NIRS as a complementary, intensity-aware monitoring tool—particularly for delineating the heavy/severe-intensity boundary and detecting peripheral metabolic limitations—rather than as a stand-alone replacement for ventilatory or lactate thresholds. Because much of the evidence derives from small, single-sex or athlete-only cohorts, these findings should be regarded as a promising basis requiring further validation in broader NCD populations. Implementation in NCDs requires standardized placement and calibration protocols, sex- and body composition-stratified reference values, motion-artifact mitigation, and adequately powered longitudinal trials in clinical populations. Full article

Background/Objectives: In Saudi Arabia, noncommunicable diseases (NCDs) are an increasing public health concern, with almost 70% of deaths related to chronic diseases. The study aimed to analyze 33-year trends in NCD risk factors and apply machine learning (ML) models to identify ecological associates of premature NCD-related mortality, sex-specific analyses and project trajectories to 2030. Methods: A longitudinal ecological time-series design which used WHO Global Health Observatory (GHO) NCD Indicators (1990–2022; select lipid indicators from 1980). Five supervised regression ML models—OLS, LASSO, Ridge, Random Forest, and Gradient Boosting—were trained with TimeSeriesSplit cross-validation (five folds) to preserve temporal order and prevent data leakage. A formal PELT changepoint algorithm confirmed trend breakpoints. Linear projections to 2030 were estimated with 95% prediction intervals. Results: Adult obesity increased by +20.6 percentage points (pp) over 33 years. Under a no-policy-change scenario, female obesity is projected at 50.3% by 2030 (95% PI: 50.0–50.5%). Premature NCD mortality declined by −5.9 pp. Under TimeSeriesSplit CV, all models yielded negative R², confirming LOOCV R² = 0.98 reflected shared time-trend artefacts; the ML component is reframed as descriptive feature-importance analysis. The obesity sex gap (female minus male) was the strongest ecological associate of premature NCD mortality. Diabetes treatment coverage showed a strong inverse ecological association (r = −0.913). Conclusions: NCD risk factors in Saudi Arabia are evolving in complex ways. Targeted interventions addressing sex-specific disparities and healthcare system performance are urgently needed to meet national and global NCD targets. Full article

The HORUS project investigates the interface between urban planning and public health, focusing on the reduction in non-communicable diseases through innovative urban planning and technological integration. Using geographic information systems, the project will develop advanced urban mapping and analysis tools to visualize and tackle health inequalities. The participatory approach of technologies will actively engage communities and empower citizens to shape a healthier urban environment. Through multidimensional methodology, including qualitative research and natural experiments, HORUS will align urban planning with public health needs. The project will target modifiable risk factors (physical inactivity, unhealthy diet and substance use) and will promote behavior change and environmental redesign to reduce the prevalence of non-communicable diseases. The integration of digital technologies will not only improve the assessment of urban health but also facilitate evidence-based interventions tailored to vulnerable populations. HORUS will provide practical applications for policy makers and urban planners by providing actionable frameworks for incorporating health-promoting features into urban design. This holistic approach will help create resilient cities that prioritize public health and shape the future urban environment. The project is an example of the transformative potential of aligning technology, policy and community engagement to effectively address the challenges of urbanization, and non-communicable diseases. Full article

Emerging research highlights the complex interplay between the gut microbiome, skin health, and environmental exposures, forming what is now recognized as the gut–skin–exposome axis. This narrative review explores the role of gut microbiome dysbiosis—a disruption in the balance of intestinal microorganisms—in the pathogenesis and progression of various non-communicable inflammatory skin diseases, including acne, atopic dermatitis, psoriasis, rosacea, systemic lupus erythematosus, chronic spontaneous urticaria, hidradenitis suppurativa, and alopecia areata. This review synthesizes mechanistic studies, clinical trials, and Mendelian randomization data to elucidate how altered gut microbial composition contributes to systemic and cutaneous inflammation. Key modifiable factors, such as diet, antibiotics, stress, and sleep, as well as interventions like probiotics, prebiotics, synbiotics, and fecal microbiota transplantation, are discussed for their potential therapeutic value. By integrating clinical insights with microbiome science, this review underscores the importance of a holistic, systems-based approach in managing inflammatory skin diseases, offering clinicians evidence-based strategies to improve patient outcomes through gut microbiome modulation. Full article

Between 2020 and 2025, Europe has faced multiple interacting public health threats shaped by and following the COVID-19 pandemic. Alongside COVID-19, the region experienced other infectious disease events, including monkeypox, measles resurgence, legionellosis and acute hepatitis of unknown origin in children. At the same time, non-communicable disease burdens, including obesity, type II diabetes mellitus, disruption of chronic disease care, mental health disorders and increased problematic digital use, intensified during and after the pandemic period. Antimicrobial resistance (AMR) remained a major cross-cutting threat because it undermines the effective treatment of infections and weakens emergency preparedness. This narrative review synthesizes peer-reviewed articles and selected reports from international organizations for the 2020–2025 period, using COVID-19 as the organizing context for examining interconnected infectious, chronic and system-level threats. Across these topics, recurring themes included vaccination gaps, fragmented surveillance, disruption of routine care, health system inequities, misinformation and insufficient preparedness for cross-border threats. The review supports integrated surveillance, continuity plans for essential services, stronger vaccination and risk-communication strategies and sustained AMR stewardship within a One Health framework. Coordinated action across public health, primary care, mental health and chronic disease policy is essential for future resilience. Full article

Over the past decade, Portugal has increasingly focused on public policies that promote healthy eating, driven by growing concerns about the population’s health and its social, economic, and political effects. These policies aim to reduce unhealthy eating habits, which are major risk factors for disease, and to reduce the overall disease burden. Tax measures are specifically intended to curb the consumption of foods high in sugar, salt, and saturated fats to prevent chronic non-communicable diseases such as obesity, type 2 diabetes, and cardiovascular disease. This article analyzes the measures adopted in Portugal to reduce sugar consumption and examines their effects on tax revenue and consumption volume. Using document analysis, the results indicate a decrease of 3853 tons in sugar consumption and tax revenue of 432 million euros from taxing sugary drinks and sweeteners since 2017. Although significant progress has been made, including product reformulation to reduce sugar content, challenges remain. It is essential to continue and expand these policies to other products, along with ongoing impact assessments, to foster a healthier future in line with the World Health Organization’s guidelines for 2030. Full article

Chronic non-communicable diseases are closely linked to low-grade inflammation and oxidative stress. Native Brazilian fruits, rich in bioactive compounds such as polyphenols and carotenoids, have recognized antioxidant, anti-inflammatory, and neuroprotective properties. Mechanisms of action included inhibition of NF-κB signaling, downregulation of pro-inflammatory cytokines, modulation of oxidative biomarkers, and improvement of metabolic parameters. Several studies demonstrate protective effects against insulin resistance, hepatic steatosis, cardiovascular alterations, and neuroinflammation, alongside modulation of gut microbiota. Most evidence is from animal or cell models, with scarce clinical trials, limiting translational applicability. Overall, native Brazilian fruits represent promising dietary sources of bioactive compounds that may contribute to the modulation of oxidative stress and chronic inflammation. Challenges include variability in phytochemical content due to species, maturity, processing, a lack of standardized extraction and dosage protocols, and limited bioavailability data. Although preclinical findings are robust, further controlled human trials are necessary to confirm their efficacy and clarify their role in the clinical management of inflammatory and neurodegenerative diseases. Full article