Search Results (9,714)

Diet represents a key determinant of the body’s acid–base balance because foods are metabolized into non-volatile acids or bases. An increase in dietary acid load can elicit low-grade metabolic acidosis, which has been associated with systemic inflammation and the risk of adverse cardiometabolic conditions, including obesity. Potential renal acid load (PRAL) and Net Endogenous Acid Production (NEAP) represent the major markers of dietary acid load. The aim of this secondary analysis was to compare the acid load of four different diets and investigate its association with Body Mass Index (BMI) in a sample of the general population. In an online survey, the INVITA study, four dietary patterns (meat-eaters, fish-eaters, lacto-ovo-vegetarians, and vegans) were compared for their corresponding PRAL and NEAP values, and the associations of both parameters with BMI were evaluated. Multiple linear regression models were progressively adjusted for dietary pattern, energy intake, age, sex, physical activity, smoking status, and education level. The stepwise decrease in animal food consumption across the four dietary patterns was associated with a progressive reduction in dietary acid load, with vegan participants showing the lowest values. While PRAL did not prove consistently associated with BMI in this cohort, NEAP remained significantly associated with BMI even after full adjustment for lifestyle confounders (β = 0.032, p = 0.00013). However, because NEAP includes an anthropometric component based on body surface area, this association should be interpreted cautiously, as it may partly reflect mathematical coupling rather than a purely diet-derived effect. PRAL should be considered the more diet-specific marker, while NEAP represents a composite index combining dietary acid load and anthropometric scaling. Because PRAL and NEAP do not account for protein origin, future studies should assess whether diet-specific reference ranges could improve their comparisons for dietary patterns including mostly or exclusively plant protein. Full article

Maternal obesity and a Western diet high in fat and sugars are increasing worldwide and may contribute to rising neurodevelopmental and neurobehavioral disorders in offspring. Both human and animal studies link these factors to adverse outcomes. However, the cellular mechanisms driving altered early-life neurogenesis, particularly in the hippocampus, remain unclear. To assess fructose effects on neural stem cell (NSC) differentiation and neuronal morphology, hippocampal NSCs from E12.5 C57BL/6 mouse embryos were cultured and treated with fructose (8.75 or 12.5 mM) for 7 days. Neuronal and astrocyte populations, along with neuronal morphology, were analyzed by immunofluorescence, and protein expression was assessed by Western blot. Fructose treatment significantly reduced neuronal and increased astrocyte counts, leading to a decreased neuron-to-astrocyte ratio compared to controls. These findings were supported by decreased MAP2 (neuronal) and increased GFAP (astrocyte) protein expression. Furthermore, fructose also significantly reduced neurite lengths without affecting neurite number. Morphological analysis revealed decreased soma size, reduced area/perimeter, and altered soma area-to-perimeter ratios, indicating impaired structural integrity. Thus, fructose exposure shifts NSC differentiation toward an astroglial lineage while suppressing neuronal development and impairs neuronal growth and structural complexity. Future studies are necessary to determine the influence of these cellular changes on synaptic plasticity and learning, as well as memory. Full article

Background/Objectives: Problematic digital technology use may be associated with unhealthy dietary behaviors, but different forms of digital dependence may not relate to diet quality in the same way. This study examined the association between Mediterranean diet adherence and problematic smartphone, Internet, and video game use in young adults. Methods: A cross-sectional study was conducted in 496 adults aged 18–34 years participating in the EVA-Adic study. Mediterranean diet adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). Problematic digital use was evaluated using the EDAS-18 for smartphone dependence, the Compulsive Internet Use Scale (CIUS), and the Questionnaire of Experiences Related to Video Games (CERV). Multivariable regression models were adjusted for sociodemographic, anthropometric, and lifestyle factors. Results: Of the participants, 339 had low-to-moderate Mediterranean diet adherence, and 157 had high adherence. In fully adjusted models, higher EDAS-18 scores were associated with lower MEDAS scores (β = −0.022; 95% CI: −0.041 to −0.003), whereas higher CIUS scores showed a small positive association with MEDAS scores (β = 0.025; 95% CI: 0.002 to 0.049). CERV scores and the global digital addiction index were not associated with overall Mediterranean diet adherence. At the individual dietary-component level, higher smartphone dependence was associated with lower compliance with fruit and sugar-sweetened beverage recommendations. Conclusions: In this cross-sectional sample of young adults, smartphone dependence and compulsive Internet use showed small associations with Mediterranean diet adherence in opposite directions, whereas problematic video-game use and the exploratory global composite were not associated with the overall MEDAS-14 score. The magnitude of the observed associations was modest; their clinical and public-health relevance remains uncertain, and the component-level findings should be considered exploratory in the context of multiple testing. These results do not establish causality and require confirmation in longitudinal, multicenter studies using objective and context-specific measures of digital use. Full article

Background/Objectives: Multiple sclerosis is frequently associated with sleep disturbances and circadian rhythm disruptions. This study evaluated the effects of the Mediterranean diet (MedDiet) (n = 17) and time-restricted eating (TRE) (n = 17) on sleep, chronotype, and appetite-related parameters in females with relapsing–remitting MS. Methods: In this 12-week randomized comparative pilot trial, 34 female patients with RRMS were randomly assigned to either a MedDiet or TRE (16:8 protocol) group. Individualized eucaloric diet plans were provided to maintain baseline weight. Biochemical parameters (fasting glucose, lipid profile, leptin, and ghrelin levels), anthropometric measurements, the Pittsburgh Sleep Quality Index (PSQI), the Morningness and Eveningness Sleep Questionnaire (MEQ), and dietary intake were assessed at baseline and week 12. Results: Both groups showed significant reductions in body mass index, waist and hip circumference, although no statistically significant changes were observed in reported energy intake. In the MedDiet group, LDL (101.88 vs. 99.12 mg/dL) and total cholesterol (178 vs. 173 mg/dL) decreased before correction for multiple comparisons (p < 0.01); however, these findings did not remain statistically significant after multiple-comparison correction. Leptin and ghrelin showed no significant changes in either group. Both groups increased dietary protein, fiber, and water intake and decreased fat intake, while carbohydrate intake remained unchanged. MEQ scores increased only in the MedDiet group (p = 0.035). Mixed-design ANOVA revealed a significant time effect on PSQI scores independent of diet type (F = 11.370, p = 0.002), although this effect could not be attributed to a specific dietary intervention. Conclusions: Both diets were associated with changes in anthropometric measures. The MedDiet was associated with increased MEQ scores and trends toward favorable changes in lipid parameters, suggesting a shift toward a more morning-oriented chronotype rather than a direct effect on circadian rhythm. No significant changes were observed in sleep quality or appetite-related hormones. Further studies with larger samples and longer durations are needed. Full article

Background: Post-COVID-19 condition (PCC) remains a public health concern due to persistent metabolic and inflammatory alterations, especially among ICU survivors. Oxidative stress is involved in PCC pathophysiology, and the Mediterranean diet may be associated with redox balance. Objective: To evaluate the association between Mediterranean diet adherence (main exposure variable) and oxidative stress/redox stress biomarkers (primary outcomes) in ICU survivors with persistent symptoms after severe COVID-19. Additionally, body composition and inflammatory markers were explored as secondary outcomes related to redox status. Methods: This cross-sectional study included 123 adult ICU survivors with PCC (51 ± 13.2 years; 53% men; 75% with obesity). Protein carbonyls, TBARS, sulfhydryl groups, glutathione, CRP, albumin, and IL-6 were measured. Diet adherence during post-COVID-19 outpatient follow-up was assessed using MEDAS, and body composition by DXA. Participants were categorized by the median score, and Poisson regression models were applied. Results: The median MEDAS total score was 4 (IQR 2–5), indicating overall low adherence to the Mediterranean diet. Lower adherence was associated with higher glutathione levels (p = 0.04), with no differences in pro-oxidant markers. Higher sulfhydryl levels were associated with lower body fat, higher appendicular skeletal muscle mass, and lower CRP and IL-6. Conclusions: Low adherence was frequent and associated with antioxidant differences. Redox status was also associated with body composition and inflammatory markers. Full article

Background/Objectives: Male obesity secondary hypogonadism (MOSH) is a highly prevalent condition characterised by reduced testosterone levels in obese men, driven by increased aromatase activity, reduced SHBG, insulin resistance, and HPG axis suppression. Dietary interventions represent a cornerstone of non-pharmacological management; however, the comparative efficacy of different dietary patterns on testosterone restoration remains unclear. Methods: We conducted a systematic literature review following PRISMA 2020 guidelines. Comprehensive searches were performed in SciSpace, Google Scholar, and PubMed through June 2026. Eligible studies included human adult males with obesity (BMI ≥ 30 kg/m²) undergoing Mediterranean diet (MedDiet), ketogenic diet (KD/VLCKD), or intermittent fasting (IF) interventions, with quantitative assessment of testosterone or androgen status. Results: From 697 initial records, 500 unique papers were identified after deduplication. Following abstract screening (n = 442 excluded) and full-text assessment (n = 6 excluded), 52 studies were included in the final synthesis. VLCKD demonstrated the most consistent evidence for testosterone improvement, with RCTs reporting significant increases in total testosterone (+1.5 to +3.0 nmol/L). Intermittent fasting showed promising but more heterogeneous results. Evidence for Mediterranean diet was limited, focusing primarily on metabolic rather than hormonal outcomes. Weight loss emerged as a critical mediator across all dietary interventions (~3 nmol/L per 10 kg weight loss). Conclusions: Among dietary interventions for MOSH, VLCKD shows the strongest evidence for testosterone restoration in obese men, through rapid weight loss, improved insulin sensitivity, reduced inflammation, and potential direct HPG axis effects. Intermittent fasting represents a viable alternative. Mediterranean diet, while beneficial for cardiovascular health, lacks robust interventional evidence for testosterone improvement in this population. Systematic Review Registration: This review was not prospectively registered. PROSPERO registration is recommended for future updates. Full article

Nutrition, healthcare and management of the rearing environment all interact and have an impact on the performance and feed efficiency of pre-weaned dairy calves. In a survey of 54 dairy farms in Northern Ireland, average daily gain (ADG) of 369 pre-weaned calves was assessed. Dietary and nutritional information detailing intake of milk or calf milk replacer (CMR) and the composition of milk/CMR and solid feed diets was collected. Environmental and hygiene-related parameters within calf rearing facilities were recorded. It was hypothesised that suboptimal environmental management conditions would negatively affect calf performance and cause the observed average daily gain and retained energy to fall below values predicted from nutritional intake alone. Factors that tended to be negatively associated with the observed calf ADG were increased time (>50%) below lower critical temperature (LCT), increased time (>10%) above 0.4 m/s airspeed and reduced straw dry matter (<70%). Potential calf ADG was predicted using the young calf model from the Nutrient Requirements of Dairy Cattle (8th Edition). The predicted and observed calf ADG and retained energy (RE) were compared to assess whether the individual observed calf ADG was greater, equal to or less than that predicted by the model. Environmental factors associated with calf ADG or RE being less than the model prediction included: greater than 30 animals housed in the calf house, increased time (>10%) above 0.4 m/s airspeed and where coliforms were detected in ≤50% of milk samples on that farm. These results demonstrate the relevance of management of the rearing environment in optimising pre-weaned calf performance and feed efficiency. Full article

Environmental exposures throughout life play a major role in shaping human health and contribute to the onset and progression of numerous chronic diseases, including neurodegenerative disorders and cancer. These effects arise from complex interactions between environmental pollutants, diet, lifestyle, occupation, genetic background, and other biological and socioeconomic factors. Although recent advances in omics technologies have substantially improved our understanding of the molecular mechanisms underlying these interactions, most studies continue to adopt reductionist approaches that fail to capture the complexity of the environment–health–disease continuum. We propose a comprehensive conceptual framework based derived from the existing literature for investigating lifelong environmental exposures through a multilevel and multidimensional strategy. Four complementary levels are defined: (i) molecular alterations characterized using ionomics, metallomics, proteomics, metabolomics, transcriptomics, genomics, and integrated multi-omics; (ii) tissue and organ alterations assessed by imaging technologies and radiomics; (iii) population-level variability investigated through epidemiological approaches (epidemiomics); and (iv) the integration and interpretation of heterogeneous datasets using artificial intelligence. Representative applications of these methodologies are discussed to illustrate their potential for identifying biomarkers, elucidating disease mechanisms, and improving exposure assessment. Particular attention is given to the integration of molecular, imaging, and epidemiological data to establish more robust causal relationships between environmental exposures and health outcomes. The proposed framework highlights the need for multidisciplinary collaboration and advanced computational tools to address the complexity of exposome research. Ultimately, this integrative approach may support early disease detection, personalized prevention strategies, and the development of evidence-based environmental, occupational, and public health policies aimed at reducing the burden of environment-related diseases. Full article

Background: Oral diseases remain a major public health challenge globally and in Hungary, where untreated caries, periodontal disease, and edentulism are highly prevalent. Diet is a key modifiable determinant of oral health, yet the cumulative impact of multiple unfavorable nutritional behaviors on self-perceived oral health has not been assessed at the national level in Hungary, nor have population-attributable fraction (PAF) estimates been reported. Methods: This cross-sectional study analyzed data from 5146 adults in the 2019 Hungarian European Health Interview Survey. A six-component nutritional-risk score was constructed from self-reported dietary behaviors (fruit intake, vegetable intake, sugary soft drink consumption, sweets consumption, processed meat consumption, and water intake). Survey-weighted logistic regression estimated associations between nutritional-risk categories and poor self-perceived oral health, adjusting for sociodemographic, lifestyle, and health-related covariates. Counterfactual PAFs with 95% Monte Carlo uncertainty intervals (1000 bootstrap replications) were estimated for three nutritional-risk scenarios. Results: The weighted prevalence of poor self-perceived oral health was 19.2%. Compared with participants with 0–1 unfavorable nutritional factors, those with 3 factors (OR = 1.37; 95% CI: 1.09–1.73) and 4–6 factors (OR = 1.46; 95% CI: 1.15–1.85) had significantly higher odds of poor oral health. Low water intake was independently associated with poor oral health (OR = 1.38; 95% CI: 1.16–1.64). The main counterfactual PAF analysis estimated that 16.1% (Monte Carlo 95% UI: 5.93–26.48%) of poor oral health burden was attributable to unfavorable nutritional profiles. High nutritional risk was also associated with active caries, gum bleeding, and tooth loss. Conclusions: Cumulative nutritional risk is independently associated with poor self-perceived oral health in Hungarian adults. Integrating dietary improvements into oral health prevention strategies may substantially reduce the population-level burden of oral disease. Full article

Type 2 diabetes mellitus represents an important worldwide health problem. Annona muricata L. (AM) is used for diabetes management. Additional research is required to elucidate its hypoglycemic mechanism; we evaluate its effect on serum leptin, glucagon, insulin, neuropeptide Y concentrations and protein levels of glucagon and insulin in diabetic model. Diabetes was induced in male Wistar rats using a high-fat diet (HFD) combined with 35 mg/kg streptozotocin (STZ). The animals were randomly assigned to four groups (n = 5): Ctrl (healthy animal), HFD (untreated HFD), AM (50 mg/kg of AM) and HFD Met (300 mg/kg of metformin). Treatments were administered orally for four weeks. Serum levels of leptin, glucagon, NPY, insulin, lipid renal and hepatic profiles were quantified before and after treatment. Pancreatic insulin and glucagon content were assessed by immunohistochemistry. Two-way ANOVA with repeated measures (intragroup) and ANOVA (intergroup) were used. The HFD AM group showed lower serum glucose (41.2%), total cholesterol (38.8%), triglycerides (69.6%) and NPY (73.4%) levels than pretreatment values (p < 0.05). Increased serum leptin concentration (53.7%), pancreatic insulin (42.0%), and glucagon (48.0%) protein levels (p < 0.05) were observed. Our study provides additional insights into the hypoglycemic effects of AM and supports its potential use as a complementary treatment for diabetes. Full article

Background/Objectives: School-based programmes may play an important role in promoting healthier and more sustainable dietary habits from early childhood. This study described and evaluated a community-based intervention aimed at promoting Mediterranean diet (MD) principles, improving food literacy, and raising awareness of sustainable food practices among primary school children in the Tagus Lezíria region, Portugal. Methods: The intervention was implemented in 23 schools across 11 municipalities and included two seasonal rounds of participatory educational activities focused on healthy eating, local and seasonal foods, sensory exploration, balanced meals, composting, food storage, sustainable food production, and food waste prevention. A total of 872 children participated in the intervention activities, and 370 provided paired baseline and follow-up KIDMED assessments. Results: The mean KIDMED score decreased significantly from 8.0 ± 2.2 at baseline to 7.5 ± 2.4 after the intervention. Overall, 31.6% of participants improved their score, 18.9% showed no change, and 49.5% showed a decrease. The proportion of children who did not skip breakfast increased from 79.8% to 88.6%, and avoidance of fast-food restaurants more than once weekly increased from 85.4% to 89.6%. Smaller favourable changes were observed for pastry, sweet, and fish consumption, and olive oil use, whereas fruit, vegetable, pulse, and nut consumption did not improve. Conclusions: The intervention produced heterogeneous outcomes. Although overall MD adherence decreased, almost one-third of participants improved individually, with favourable changes in breakfast and selection of less healthy behaviours. Longer programmes with stronger family involvement may be required to reinforce core MD foods and achieve broader, sustained improvements. Full article

As obesity, diabetes and other diet-related metabolic disorders continue to rise, non-nutritive artificial sweeteners (NASs) are widely used as sugar substitutes in free-sugar reduction and weight-management strategies, but their effects on the gut microbiota, host metabolism and related health outcomes remain debated. To clarify this evidence landscape, this review synthesizes current knowledge on the effects of major NAS on the gut microbiota and host metabolic and health-related outcome. A bibliometric analysis was conducted to characterize the development, knowledge structure and thematic evolution of this research area. For the eight NAS exposure categories included in this review (saccharin, cyclamate, aspartame, acesulfame potassium, sucralose, neotame, neohesperidin dihydrochalcone and mixed NAS), we performed a compound-specific analysis integrating physicochemical characteristics, regulatory status, and research findings from in vitro, ex vivo, animal and human studies on gut microbiota alterations, host metabolic and health-related outcomes. These findings were further compared through four interpretive dimensions: exposure conditions, research model background, outcome assessment and interpretation of discordant results. Current research evidence does not support a class-wide conclusion that NAS are uniformly harmful or safe. To make research findings searchable, we developed the NAS-MAP knowledge graph, an interactive non-nutritive artificial sweetener–microbiota-associated phenotype knowledge graph. Overall, this review consolidates current knowledge, clarifies the sources of inconsistent findings, and provides a framework for more mechanistically informative studies, standardized evidence reporting, and more precise sweetener-, exposure- and population-specific dietary and public health guidance. Full article

The liver’s regenerative capacity is essential for resection and transplantation, but chronic liver diseases compromise this ability. Conventional preoperative tests poorly predict regeneration in diseased livers, necessitating new intraoperative tools. Optical coherence tomography (OCT) provides real-time high-resolution “optical biopsy” and functional tissue assessment, making it a promising method for evaluating liver regenerative potential. The aim of this study was to identify characteristic criteria derived from MM OCT that could be used intraoperatively to detect the presence and type of pathology, and to assess the reduction in liver regenerative potential in patients. In this study, we used intraoperative multimodal OCT (MM OCT)—combining attenuation mapping and elastography—for real-time, label-free assessment of changes in liver structure, and stiffness during regeneration. MM OCT also provides higher resolution and specificity than conventional clinical imaging. In a rat model, we induced steatosis by high-fat diet and fibrosis by CCl₄ injections, then induced regeneration by 70% partial hepatectomy (PH). MM OCT monitoring was performed on day 0 (pre-PH), day 3, and day 7 (post-PH). Pathologies and regeneration were verified by biochemical blood tests, histological analysis, and real time-PCR for steatosis- and fibrosis-specific genes. As a result, attenuation coefficient and Young’s modulus obtained by MM OCT enable real-time assessment of liver tissue changes in steatosis and fibrosis, which vary with regeneration stage. Steatosis showed uniformly high attenuation and low stiffness before and after resection. Fibrosis exhibited heterogeneous attenuation and marked stiffness fluctuations—high pre-resection values dropped at day 3 and rose again by day 7. Attenuation coefficient detects lipid droplets in hepatocytes and identifies high-density hepatocyte zones near collagen septa, distinguishing them from densely packed unaltered cells. Thus, MM OCT identifies pathology type, lipid infiltration and collagen presence—features that serve as indicators of impaired liver regenerative capacity. Full article

Objectives: Celiac disease (CD) is an immune-mediated disorder triggered by gluten ingestion. Although a gluten-free diet (GFD) is the only effective treatment, patients may still experience inflammation, nutritional imbalances, and reduced quality of life. Physical activity (PA) has demonstrated anti-inflammatory benefits; however, its role in CD management remains unclear. This systematic review aimed to synthesize evidence on the associations of PA and the outcomes of exercise interventions in individuals with CD, focusing on metabolic, nutritional, clinical, and functional outcomes. Methods: Following PRISMA guidelines, we included peer-reviewed observational and experimental studies assessing PA in individuals with CD across all age groups, without language or date restrictions. Searches were conducted in PubMed, Scopus, Web of Science, EMBASE, and SPORTDiscus. The risk of bias was evaluated using JBI and Cochrane RoB 2 tools. Results: Fourteen studies (17 publications) were included, the vast majority of which were cross-sectional, along with one quasi-experimental study and two randomized controlled trial cohorts reported across five publications. Data from these predominantly observational studies suggested possible, yet inconsistent, links between higher PA levels and better profiles in body composition, inflammatory and oxidative markers, quality of life, and psychological outcomes. Positive associations were also observed in some studies regarding gastrointestinal symptoms and adherence to the GFD. However, findings on metabolic markers and bone mineral density were inconsistent and linked to dietary factors. Conclusions: While PA represents a potential adjunct in the comprehensive management of CD, particularly in relation to functional and inflammatory outcomes. However, the current evidence remains highly preliminary, limited, and inconsistent, which restricts the strength of any definitive conclusions. Therefore, high-quality, longitudinal studies and well-designed clinical trials are needed to confirm its long-term benefits, especially in the pediatric population, and to establish specific recommendations. Full article

Background: Children with food allergy (FA) may develop eating difficulties that extend beyond medically required allergen avoidance, including food neophobia, selective eating, and avoidant/restrictive food intake disorder (ARFID)-related symptoms. This mixed-methods study aimed to assess ARFID symptoms, food neophobia, diet quality, and food-related psychological experiences in children with FA. Methods: Seventy children with confirmed FA were enrolled in an observational cross-sectional mixed-methods study conducted at a tertiary pediatric allergy center. Quantitative assessment included the Eating Disorders in Youth-Questionnaire (EDY-Q), the Italian Child Food Neophobia Scale (ICFNS), and the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED). Qualitative data were collected from a purposive subsample of 26 children through semi-structured child-friendly interviews and drawing-based elicitation activities and were analyzed using inductive thematic analysis. Results: A positive EDY-Q screening result for ARFID-related symptoms was observed in 3 children (4.3%). Selective Eating showed the highest median EDY-Q domain score (median 1.50, IQR 0.67–4.00), followed by Food Avoidance Emotional Disorder (median 1.00, IQR 0.00–2.00) and Functional Dysphagia (median 0.00, IQR 0.00–2.00). Moderate food neophobia was observed in 45 children (64.3%), while 24 children (34.3%) were classified within the high food-neophobia category. KIDMED score was negatively correlated with EDY-Q total score (Spearman’s ρ = −0.302; p = 0.011), Selective Eating (ρ = −0.356; p = 0.002), and Functional Dysphagia (ρ = −0.238; p = 0.048). In an exploratory hierarchical regression, Selective Eating remained inversely associated with KIDMED after adjustment for demographic and FA-related covariates (β = −0.386; p = 0.002); however, the overall model did not reach statistical significance (p = 0.081), and the additional clinical covariates did not significantly improve model fit. Accordingly, the fully adjusted findings should be interpreted as exploratory. Qualitative analysis identified five themes: anticipatory fear of food and tasting, emotional memory of allergic reactions and generalization of risk, selective avoidance and food rigidity, reassurance-seeking and decision-making dependence, and ambivalent parental dynamics. Conclusions: Within this tertiary-care sample, positive EDY-Q screening results were uncommon, whereas broader food-related difficulties were identified. Pediatric FA assessment may benefit from attention to eating behavior, diet quality, and avoidance extending beyond confirmed allergens. Full article