Search Results (117)

Background/Objectives: Diet is an essential factor influencing health and the preventive management of some diseases. There is little research to date on the diet of organic food producers, particularly organic ones. The present study aimed to investigate the diet quality of organic and conventional fruit growers. Methods: Fifty-three fruit growers, including 28 organic and 25 conventional, took part in the study. Body weight and height were measured. Body composition was estimated using the BIA method. Information on dietary intake was collected using a 3-day dietary record. Diet quality scores were calculated using the Healthy Eating Index-2015 (HEI-2015) and the Diet Quality Index International (DQI-I). Results: The diet quality of the orchardists was low (31.7 ± 9.3 points on the HEI scale and 54.3 ± 7.5 points on the DQI-I scale). Organic fruit growers scored significantly higher on both scales, compared to conventional fruit growers (p < 0.001 and p = 0.002 for HEI and DQI-I, respectively) and had a lower percentage of BF and a higher percentage of FFM and TBW in their bodies (p = 0.013, p = 0.049 and p = 0.049, respectively). Consumers of organic products had better diet quality scores, and diet quality increased as the percentage of organic food consumption increased. Both diet quality and the percentage of organic food consumed were associated with participants’ self-assessed nutritional knowledge. Conclusions: Diet quality was associated with the type of agricultural practice and with organic food consumption. As a pilot cross-sectional study based partly on self-reported measures, the observed differences should be interpreted cautiously. They may also partly reflect broader lifestyle-related factors. Further research on similar groups is needed to confirm these relationships, preferably with an assessment of respondents’ nutritional knowledge. Full article

Background/Objectives: Preterm birth (PTB) is a major public health concern worldwide, which may lead to detrimental maternal and neonatal outcomes. Maternal nutritional status, gestational weight gain (GWG), and lifestyle factors are potentially modifiable determinants of adverse pregnancy outcomes. This study examined the association between PTB and maternal GWG and assessed whether maternal dietary habits and lifestyle factors were related to GWG in women delivering preterm versus at term. Methods: A retrospective case–control study was conducted at a tertiary center in Hungary (MANOR Study, 2019). The case group included n = 100 women with PTB, while n = 200 matched term deliveries served as controls (1:2 ratio). Data were collected using a self-administered questionnaire and medical records. Pre-pregnancy body mass index (BMI) was categorized using standard definitions, while GWG was classified as inadequate, recommended, or excessive according to the US 2009 Institute of Medicine guidelines. A 7-item dietary index score was calculated based on gestational dietary habits. Results: Pre-pregnancy BMI distribution did not considerably differ between groups (p > 0.05); over one-third of women in both groups were overweight or had obesity (38.7% vs. 36.7%). Previous PTB (p < 0.001) and gestational hypertension (GHT) (p = 0.003) were more common among current PTB cases, while smoking, alcohol consumption, and gestational diabetes mellitus (GDM) showed negligible differences (p > 0.05)—28.0% of cases, and 34.5% of controls were classified as having healthy dietary habits, based on the dietary index score calculated. Inadequate GWG was more prevalent among PTB cases (49.0% vs. 26.8%), whereas excessive GWG was less frequent among cases (21.9% vs. 38.4%). Being within the recommended GWG range and the manifestation of gestational hypertension were associated with lower (aOR: 0.39; 95% CI: 0.18–0.87; p = 0.020) and higher (aOR: 3.43; 95% CI: 1.44–8.19; p = 0.005) odds of PTB, respectively. Conclusions: Inadequate GWG was more common in PTB, while excessive GWG was more frequent in term pregnancies. Fast-food consumption was associated with excessive GWG among term births. Optimizing GWG and improving maternal diet quality should be included as key, cross-cutting interventions targeting the improvement of antenatal care. Full article

Background: Diet quality and food processing patterns are increasingly recognized as important determinants of Crohn’s disease (CD) risk and disease outcomes; however, direct comparisons with healthy populations using integrated nutrient- and processing-based frameworks remain limited. Therefore, we aim to quantify ultra-processed food (UPF) consumption using the NOVA classification, compare UPF intake between CD patients and healthy controls, and assess its association with diet quality indices. Methods: Baseline dietary intake data were analyzed from two randomized controlled trial cohorts: adults with mild to moderately active CD enrolled in the Crohn’s Disease Therapeutic Dietary Intervention (CD-TDI) trial (n = 64; NCT04596566), and healthy adults participating in the MAPMed study (n = 33, NCT06765369). Dietary intake was assessed using two non-consecutive 24 h recalls collected with the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24^®). Energy-normalized macronutrient and micronutrient intakes were compared with Dietary Reference Intakes (DRIs). Overall diet quality was evaluated using the Healthy Eating Index-2020 (HEI-2015), Alternate Mediterranean Diet score (aMED), and Dietary Inflammatory Index (DII). Foods were classified according to the NOVA food processing system to estimate total and proportional energy intake from UPFs (NOVA group 4). Results: Both the CD cohort and healthy cohort exhibited suboptimal dietary patterns, with HEI scores indicating a need for improvement, low adherence to the Mediterranean diet (aMED), and neutral-to-pro-inflammatory DII scores, with no significant between-group differences (all p > 0.05). Although total energy intake differed between groups (p = 0.04), the proportion of energy derived from UPFs (NOVA group 4) accounted for half of the total intake in both cohorts (51.3–51.8%; p = 0.55). Higher UPF intake was associated with lower HEI and aMED scores and higher DII scores. Conclusions: In this study, there were no significant differences in the dietary patterns in those with CD compared to healthy controls. The high contribution of UPFs observed in both cohorts underscores widespread suboptimal dietary quality and highlights the utility of NOVA-based food processing measures as complementary to nutrient-based assessments for understanding diet-related inflammatory burden in CD. Full article

Background/Objectives: The Mediterranean diet (MeDiet) is widely recognised as one of the healthiest dietary patterns, associated with reduced risk of chronic diseases and increased longevity. Beyond its nutritional components, the Mediterranean lifestyle encompasses a broader set of culturally rooted behaviours that may contribute to its health benefits. This study aimed to assess adherence to the Mediterranean diet and lifestyle using the MEDLIFE index and to explore how dietary and lifestyle behaviours cluster into coherent behavioural patterns. Methods: We conducted an observational study among undergraduate students in health and sports sciences and a comparison group of older adults, using an anonymous questionnaire based on the MEDLIFE index. Data were analysed using a pattern-based approach combining network analysis and score-based enrichment to characterise behavioural profiles associated with different levels of Mediterranean lifestyle adherence. Results: Network-based analyses revealed a high degree of internal coherence among dietary and lifestyle behaviours traditionally associated with the Mediterranean lifestyle. In particular, dietary restraint behaviours (e.g., limitation of sugar, salt, and snack consumption) systematically co-occurred with recommended Mediterranean food choices, indicating that positive intake and self-regulation are part of a unified behavioural framework. Score-based stratification confirmed these patterns at the individual level, with low adherence characterised by the absence of key Mediterranean components and unhealthy lifestyle habits, and high adherence reflecting an integrated profile combining healthy food choices, moderation, and lifestyle practices. Conclusions: Adherence to the Mediterranean diet reflects a holistic lifestyle strategy rather than a collection of isolated dietary behaviours. These findings support public health approaches that target coherent behavioural patterns, integrating diet, self-regulation, and lifestyle habits, rather than focusing exclusively on individual dietary components. Full article

Background/Objectives: Empirical evidence on intergenerational commensality in institutional care settings remains scarce. This pilot and feasibility study evaluated the preliminary impact of an innovative intergenerational mealtime model on older adults’ subjective well-being, self-esteem, perceived health, and food consumption in an adult day care setting. Methods: A 16-week wait-list randomised controlled pilot trial with a sequential explanatory mixed-methods design was conducted in an intergenerational centre in southern Spain. Twenty-two older adults who reside in a community living setting and attend a day care service were randomly assigned to two intergenerational dining intervention/waiting-list groups or a control group. Participants in the intervention/waiting-list groups had lunch four times per week with children 2–3 years of age, following a structured protocol. The quantitative outcomes examined included subjective well-being (WHO-5 Well-Being Index), self-esteem (Rosenberg scale), perceived health (EuroQol EQ-5D), and objective assessment of plate leftovers using photographic records and the Comstock visual estimation method. Qualitative data were collected through semi-structured interviews and ethnographic observation. The trial was registered at ClinicalTrials.gov (NCT06996418). Results: Across the study period, intervention, waiting-list, and control groups showed preliminary improvements in subjective well-being and self-esteem, but with no significant group-by-time interaction. In contrast, mixed-effects models revealed an encouraging significant reduction in plate leftovers among older adults during intergenerational meals, particularly in second courses. The reduction was consolidated during the post-intervention follow-up. Qualitative findings showed perceived improvements in emotional well-being, motivation, and appetite, thus highlighting potential relational and affective mechanisms underlying changes in eating behaviour. Conclusions: This pilot study shows promise for intergenerational commensality in adult day care settings and provides preliminary evidence of its potential to promote well-being and self-esteem and reduce food waste among older adults. Larger, multi-centre, appropriately powered trials are warranted to validate these findings. Full article

Food waste is a persistent global concern, requiring behavioral and systemic responses from consumers. The current study investigated the effect of sociodemographic factors and digital activism on food waste prevention behavior. Data from 390 respondents living in Italy (65% females, from 18 to 75 years old, grouped into four generations) were collected through an online survey covering these sections: sociodemographic variables, digital activism, knowledge, attitudes, and food waste behaviors. A Food Waste Prevention Index (FWPI) was computed to assess self-reported adherence to waste-reducing practices, and differences across three groups identified through tertiles were tested. Women displayed higher levels of digital activism; Gen Z was the most engaged generation in seeking information about food, while interest in food issues declined with age. Gender, geographical area, and dietary orientation significantly influenced food waste prevention, with women, rural residents, and individuals adopting flexitarian or vegetarian diets tending towards more virtuous behavior (higher FWPI). According to digital activism, less virtuous waste behavior (lower FWPI) was associated with a lower social media and apps usage frequency. Furthermore, higher FWPI individuals self-reported stronger sensitivity to sustainability-related topics such as circular economy, short food chains, and ethical or environmental motivations for vegetarianism. Overall, awareness and digital activism may synergistically foster more responsible food consumption, and targeted communication and digital tools can effectively support household food waste reduction strategies. Full article

The integration of smart electricity management models in buildings is a key strategy for improving living comfort and optimizing energy efficiency. The incentive mechanisms introduced by the Italian regulatory framework for widespread self-consumption and energy communities encourage the deployment of smart management systems within Collective Self-Consumption Groups (CSGs) and Renewable Energy Communities (RECs). These mechanisms drive the search for solutions that combine occupant well-being with economic benefits, thereby fostering citizen participation in aggregation models that play a key role in the transition towards a progressively decarbonized electricity system. In this context, an optimization model for the management of residential heat pumps is proposed, aimed at identifying the best compromise between thermal comfort, electricity consumption, and economic benefits. The approach developed in the research encourages citizens to take an active role without the need for burdensome commitments and/or significant changes in their daily habits, in line with the importance that users themselves attribute to these aspects. To demonstrate the potential of the proposed approach, a case study was developed on a residential building located in Sardinia (Italy). The implementation of an optimization model aimed at simultaneously maximizing economic benefits and indoor thermal comfort is simulated. The model’s economic and energy performance is assessed and compared with the results obtained using different advanced heat pump control and management strategies. Full article

Background/Objectives: Digestive problems are common in the general population and may be influenced by lifestyle, emotional status and diet. This study aimed to estimate the prevalence of digestive problems in Spanish adults and examined associated factors. Methods: Descriptive cross-sectional analysis of anonymized adult microdata from the 2023 Spanish Health Survey was performed. Data were collected using a mixed-mode design (self-administered web questionnaire with interviewer-administered follow-up). Digestive problems were recoded by combining gastric ulcer, constipation, and prescribed use of laxatives, astringent drugs, and stomach medication. Therefore, digestive problems are primarily defined as the presence of gastric ulcers, diarrhea, and/or constipation. Variables included sociodemographic, Body Mass Index (BMI), smoking, alcohol intake, physical activity, Personal Health Questionnaire Depression Scale (PHQ-8), World Health Organization Well Being Index (WHO-5), and macronutrient intake estimated from a Food-Frequency Questionnaire using the Spanish Food Composition Database (BEDCA). Group comparisons and multivariable logistic regression were conducted (95% CI; significance level set at p < 0.05). Results: Of 34,148 participants, 13,518 provided information on digestive problems; among these respondents, 3860 (28.6%) reported having digestive issues. Prevalence ranged from 5.2% to 36.5% among national territories. Higher odds (OR) of digestive problems were associated with age (OR 1.026, 95% CI 1.023–1.029), female sex (OR 1.168, 1.070–1.276), non-smoking (OR 1.240, 1.005–1.531) and ex-smoking (OR 1.447, 1.272–1.647) compared to current smokers, higher PHQ-8 scores (OR 1.040, 1.029–1.051), greater protein intake (OR 1.016, 1.009–1.023), consumption of sweet pastries (OR 1.058, 1.039–1.077), and dairy products (OR 1.027, 1.002–1.053); in contrast, lower odds were associated with higher WHO-5 scores (OR 0.985, 0.982–0.987), total fiber intake (OR 0.968, 0.949–0.987), and legume consumption (OR 0.894, 0.856–0.933). Conclusions: Digestive problems show considerable variability in prevalence among survey-based Spanish sample. Digestive problems were associated with older age, female sex, depressive symptoms, high-protein intake, and higher consumption of sweet pastries and dairy products, whereas higher well-being scores, higher fiber intake and legume consumption were associated with lower odds of digestive problems. Full article

Background/Objectives: Healthy ageing, focused on maintaining daily autonomy and cognitive function despite chronic comorbidities, poses a challenge for public health systems, especially for those aged ≥80, given the expected increase in this population. Promoting a healthy lifestyle in this group is essential to achieving this goal, with primary care services playing a key role in this effort. Therefore, our objective was to profile the participants based on these characteristics. Methods: The study included 222 non-institutionalized, dementia-free individuals (mean age 84.58 ± 3.72 years, 56.3% women) recruited from a primary healthcare service. Data were collected from medical records and interviews, including the cognitive Pfeiffer test, the functional Barthel index (BI), and ad hoc questionnaires (for lifestyle variables). Latent profiling analysis (LPA) was used to classify the participants. Results: The participants reported social support (97.7%), low-risk alcohol consumption (94.6%), adherence to the Mediterranean diet (85.1%), physical activity (74.8%), and never smoking (72.5%). Hypertension (86.5%), cataracts (74.3%), and osteoarticular diseases (68.5%) were the most frequent chronic conditions. Women showed a significantly different distribution of certain variables and a higher number of comorbidities (6.34 ± 2.38) than men (5.58 ± 2.44) (p = 0.019). After LPA, we found that 38.29% of individuals met characteristics compatible with healthy ageing, predominantly male (60%); the association of a high probability of cognitive impairment with a high degree (severe or total), exhibited by the profiles likely >85% women (18.5% of individuals); physical activity, smoking, osteoporosis, anxiety, COPD, chronic kidney disease (CKD), and creatinine blood levels exhibited statistical differences between profiles; and the probability of dependence severity was associated with an increase in age, although cognitive status conservation was associated being male. Conclusions: The studied +80 group seems to follow a healthy lifestyle, as self-reported. Women fare worse than men in resilient ageing. While common factors related to dysfunctionality did not differentiate between profiles, CKD, an increasingly common age-related condition, did. Full article

Envisaging future metro operations requires a collective and collaborative approach to understand an operator’s requirements. This study aims to gain an understanding of the current status of metro operators, as well as to identify areas of future innovation and further development. A special emphasis was given to the organisational settings—an underexplored aspect of metro operators in existing research—in addressing the following three designated areas of interest: predictive maintenance, cyber-security, and energy consumption. Therefore, to achieve an insight into metro operator’s internal operations, the study sought to engage in dialogue with operators. A literature review was first conducted to provide a foundation for analysis, and based on it, an online self-completed questionnaire survey was designed and administered to gain responses and insights from an extensive range of real-world metro operators. Follow-up face-to-face and group-wide discussions were also undertaken to obtain further detail and more specific information relating to metro operations. Through a three-dimension analysis framework, current practices, areas of consensus, and future innovative strategies of metro operators’ internal operations and organisational settings are highlighted. These insights collectively underscore the importance of adaptable strategies and cross-sector collaboration for advancing resilient, efficient, and secure metro systems. The outcome of the paper aspires to provide a strong foundation for future research as well as for future metro projects, providing an overview of the existing status of metro operators across the world. Full article

Background: This paper provides the first national analysis of antimicrobial use (AMU) of oral and parenteral dosages in Bangladesh, as well as biannual trends for the years from 2019 to 2023. It also analyzes the effect of the COVID-19 pandemic on AMU. Methods: AMU was analyzed in accordance with the WHO Anatomical Therapeutic Chemical classification and defined daily doses per 1000 inhabitants per day methodology. Data on antimicrobial medicine dispatched from manufacturers’ central warehouse was collected and categorized based on the WHO’s Access, Watch, and Reserve (AWaRe) classification. Findings: This AMU surveillance demonstrates an increase in the use of antimicrobial medicines from 2021 to 2022, and in 2023, it decreased, with our national AMU surveillance data indicating that cefixime and azithromycin were the most consumed antibiotics during this period. Most antibiotics used in Bangladesh are broad-spectrum ‘Watch’-category antibiotics. Among oral antibiotics, 50 to 67% are from the ‘Watch’-category. When considering only parenteral antibiotics, 70 to 91 % fall under the ‘Watch’-category. Third-generation cephalosporin consumption has been found to be higher than second- and first-generation cephalosporins. The oral antimicrobials are more commonly used than parenteral ones. AMU notably increased during the COVID-19 pandemic, especially in the case of systemic antibacterial use. Conclusions: To achieve the global target of 70% use of Access category antibiotics by 2030, the use of Watch-group antibiotics, like cefixime, azithromycin, ciprofloxacin, levofloxacin, and ceftibuten, needs to be reduced through investing in and strengthening stewardship programs and eliminating self-medication in Bangladesh. The findings of this study provide useful information to policymakers to tackle AMR in Bangladesh. Full article

Background/Objectives: This study aimed to assess the consumption of caffeinated beverages and the associated caffeine intake among Saudi adults, alongside a quantitative risk assessment using the hazard quotient (HQ) approach. Methods: A cross-sectional study was conducted, utilizing a validated Arabic Beverage Frequency Questionnaire to collect data on beverage consumption patterns. The participants reported the type, frequency, and quantity of caffeinated beverages consumed. We also calculated caffeine intake and assessed the associated health risks. Data were collected from 4367 participants across 13 regions in Saudi Arabia. Results: This study involved adult participants (18–65 years), with 45% females and 55% males. The mean age of the participants is 35 years. The participants reported the type, frequency, and quantity of caffeinated beverages consumed through a self-reported online survey. The most commonly consumed caffeinated beverages were Saudi coffee (79%), soft drinks (75%), and sweetened tea (69.3%). The highest consumption was observed in the 30–44 age group. The mean daily caffeine intake was 131 ± 1.4 mg/day (145 ± 2.3 mg/day for males, 120 ± 1.8 mg/day for females). Although female participants consumed more beverages, male participants had higher caffeine intake (p = 0.000). The mean HQ for caffeine exposure was 0.32, with a 95th percentile of 0.33, indicating no significant risk. Pregnant and lactating women’s caffeine intake also remained within safe limits. Conclusions: The average caffeine intake among Saudis is below 400 mg/day, suggesting no immediate health concerns. However, public health initiatives should focus on educating specific population groups about the safe limits of caffeine consumption. Full article

The aim of this study was to explore the use of neural networks as a decision-support tool for sustainable oilseed processing. The investigation focused on how different production profiles (crude vegetable oil, refined oil, hydrogenated oil and margarine) affect electricity and water use in selected Polish processing plants. The collected data were first grouped with cluster analysis to identify similar operational cases. The clusters were then visualized with a Self-Organizing Map (SOM), producing a two-dimensional topological feature map. This analysis indicated a subset of data for which it was appropriate to build predictive models of electricity and water consumption. Multi-layer perceptron (MLP) neural networks yielded highly accurate predictions of electricity (R² = 0.967 on the test set) and water (R² = 0.967 on the test set) use in oilseed processing. The resulting models can assist in selecting the most energy- and water-efficient processing configuration. Full article

In the era of digital intelligence, digital media landscapes increasingly influence cultural tourism consumption. Consumerism capitalizes on tourists’ superficial aesthetic commonalities, constructing a homogenized media imagination that leads to collective convergence in travel decisions, which obscures aspects of local culture, poses safety risks, and results in fleeting local tourism booms. In this study, semistructured interviews were conducted with 36 tourists, and NVivo12.0 was used for three-level node coding in a qualitative analysis to explore the digital media attributions of conformist travel behavior. The findings indicate that digital media landscapes exert a “digital persuasion” effect by reconstructing self-experience models, directing the individual gaze, and projecting idealized self-images. These mechanisms drive tourists to follow digital traffic trends and engage in imitative behaviors, ultimately shaping the phenomenon of “group roaming”, grounded in the psychological effect of herd behavior. Full article

Background: The opioid epidemic has highlighted the need for alternative pain management modalities in postoperative patients. Peripheral nerve blocks (PNBs) have been shown to reduce opioid consumption in the immediate postoperative period, but limited data exists on their impact on chronic opioid use. Objective: The present investigation focused on the use of preoperative PNB utilization in orthopedic surgeries and its association with chronic opioid use. Methods: A retrospective cohort study was conducted on 533 patients that had a total shoulder arthroplasty, reverse total shoulder arthroplasty, or knee arthroscopy between July 2021 and July 2024. Patients were grouped based on whether they received a preoperative PNB. Opioid prescription data were collected at 1-, 3-, and 6-month postoperative periods. In addition, a subset of patients completed a questionnaire to assess self-reported opioid consumption and other analgesic usage. Results: Patients who received a PNB were significantly less likely to report continued opioid use at one month postoperatively compared to those who did not (32.8% vs. 61.9%). Additionally, PNB recipients more often declined additional opioids due to a lack of need (p = 0.025), while those without a PNB cited other reasons, including fear of addiction or poor pain control (p = 0.033). Conclusions: The results of the present investigation suggest that preoperative PNBs may be associated with reduced chronic opioid use and have an important role in prescribing practices and pain management strategies following orthopedic surgery. Limitations: The limitations are as follows: retrospective design; potential recall and selection bias from questionnaire use; lack of data confirming actual opioid prescription fills; inclusion of patients with chronic pain comorbidities requiring long-term opioid use. Full article