Search Results (978)

Background/Objectives: Eating disorders are increasingly conceptualized as information-processing disorders characterized by attentional biases toward food-related stimuli. However, whether such biases are already detectable in subclinical, non-treatment-seeking populations remains unclear. This study examined whether subclinical eating pathology, assessed with the Eating Attitudes Test-26 (EAT-26), is associated with distinct patterns of visual attention toward high- and low-calorie food images in university students. Methods: In this cross-sectional observational study featuring an experimental eye-tracking task, 89 university students completed the EAT-26 and a visual task displaying paired high- and low-calorie food images alongside neutral controls. Oculomotor metrics included first fixation duration (FFD), fixation count (FC), and average fixation duration (AFD). Data were evaluated using EAT-26 threshold-based group stratification (lower-risk vs. risky eating behavior) and Spearman rank correlation analyses. Results: Global EAT-26 scores showed a significant correlation with a directional attentional bias index (rho = 0.29, p = 0.006). The Dieting subscale demonstrated no significant relationships with any oculomotor metrics. Conversely, Oral Control scores were significantly negatively correlated with the directional attentional bias index (rho = −0.27, p = 0.009) and positively tracked with low-calorie fixation counts (rho = 0.30, p = 0.004). Bulimia subscale scores showed a moderate positive correlation with the directional attentional bias index (rho = 0.26, p = 0.013), characterized by a significant decrease in low-calorie fixation counts (rho = −0.32, p = 0.002) and a strong increase in high-calorie fixation counts (rho = 0.36, p < 0.001) during sustained viewing. Conclusions: Subclinical eating pathology tendencies are associated with distinct implicit attentional profiles regarding food caloric density during sustained cognitive evaluation. Oral control drives visual prioritization of low-calorie stimuli to maintain inhibitory control, whereas bulimic tendencies reflect prolonged visual preoccupation with high-calorie reward cues. Eye-tracking represents a promising non-invasive research tool for exploring early cognitive correlates of eating-disorder risk. Full article

Background/Objectives: Early-onset colorectal cancer (EOCRC), diagnosed before age 50 years, is increasing in many countries, but its causes remain uncertain. Evidence on potentially modifiable determinants is heterogeneous and vulnerable to retrospective assessment and residual confounding. We synthesized metabolic, behavioral, dietary, medication-related, clinical, and socioeconomic factors, emphasizing consistency and life-course relevance. Methods: Two core PubMed searches covering publications from 1 January 2010 through 1 June 2026 were supplemented by targeted PubMed searches and reference-list screening. The present review cited 75 journal publications and synthesized the findings qualitatively; no formal risk-of-bias assessment, certainty-of-evidence grading, or de novo quantitative pooling was performed. Results: Evidence was most consistent for excess adiposity and cardiometabolic dysfunction, with earlier and persistent exposure and cardiometabolic clustering potentially more relevant. Inflammatory bowel disease emerged as a clinically distinct high-risk condition. Sedentary behavior, smoking, and higher alcohol consumption showed recurrent but heterogeneous associations. Dietary findings varied by pattern and component: sugar-sweetened beverages and lower-quality dietary patterns showed positive associations, whereas fiber- and plant-rich diets, calcium, folate, and vitamin D showed possible inverse associations. Dietary evidence was largely retrospective and does not establish causality. Evidence for aspirin and antibiotics was limited and vulnerable to confounding, precluding causal inference. Most patterns resembled later-onset CRC. Conclusions: Current evidence does not support a wholly distinct set of environmental determinants for EOCRC. Earlier exposure, longer duration, and cumulative interaction of CRC risk factors are plausible explanations but remain incompletely tested. Evidence supports life-course primary prevention, but no single factor should determine screening eligibility in isolation. Prospective studies with repeated exposure measurement are needed. Full article

Background and Objectives: Pregnancy is accompanied by physiological, hormonal, immunological, and metabolic changes that may increase susceptibility to infections and adverse maternal or fetal outcomes. This study aimed to evaluate hygiene- and nutrition-related behaviors among pregnant or previously pregnant women and to assess their associations with infections, pregnancy complications, and pregnancy outcomes. Materials and Methods: An observational, descriptive, and analytical cross-sectional study was conducted using an anonymous questionnaire administered to women aged 18–40 years from Timiș County, Romania, who were currently pregnant or had experienced at least one previous pregnancy. A total of 361 participants were included in the final analysis. Descriptive and bivariate analyses were performed, followed by multivariable binary logistic regression. Multicollinearity was assessed using variance inflation factors, and Firth’s penalized logistic regression was performed as a sensitivity analysis. Results: In multivariable analyses, occasional intimate hygiene, compared with twice-daily intimate hygiene, was associated with higher odds of vaginal candidiasis (aOR = 6.63; 95% CI: 2.29–19.17) and urinary tract infection (aOR = 4.36; 95% CI: 1.73–10.99). An unbalanced diet was associated with higher odds of pregnancy complications compared with a balanced diet (aOR = 2.33; 95% CI: 1.26–4.30). Compared with women reporting three or more supplements, women reporting no supplementation had markedly higher odds of an adverse pregnancy outcome (aOR = 46.15; 95% CI: 20.45–104.15), while each additional previous abortion was associated with higher odds of an adverse outcome (aOR = 2.25; 95% CI: 1.41–3.59). Firth sensitivity analysis attenuated the estimate for no supplementation (OR = 37.54; 95% CI: 17.89–85.32) but did not materially change the principal findings. Conclusions: Intimate hygiene frequency, nutritional supplementation, perceived diet quality, and reproductive history were associated with pregnancy-related outcomes in this study. These findings support structured prenatal assessment and counselling regarding nutrition, evidence-based supplementation, reproductive history, and appropriate hygiene practices. Because of the cross-sectional observational design and potential residual confounding, the findings should be interpreted as associations rather than causal effects. Full article

Background/Objectives: School-based food and nutrition education is an important public health strategy for developing healthy dietary behaviors during childhood and adolescence. However, limited qualitative evidence describes how nutrition teachers, who are simultaneously responsible for school meals, perceive established educational priorities and emerging needs. This study explored current and future priorities for school-based food and nutrition education in South Korea. Methods: Two online focus group interviews were conducted with eight nutrition teachers working in elementary, middle, and high schools. The interviews were transcribed and analyzed using qualitative content analysis procedures. Results: Current priorities included foundational nutrition and food-related knowledge, balanced eating, environmental issues, low-sodium and low-sugar diets, understanding school meals, prevention of eating disorders and chronic diseases, and table manners and picky eating. Future needs centered on food choice and food literacy, sustainable diets, interdisciplinary education, and understanding diverse food cultures. Across themes, participants described a shift from primarily knowledge-focused instruction toward applied dietary competence, a broadening from individual disease prevention toward health and sustainability, and stronger integration of classroom education with school meals and other subjects. Conclusions: From the perspectives of the participating nutrition teachers, the findings provide formative evidence for curricula and interventions that combine foundational nutrition science with food-choice skills, age-appropriate preventive messages, sustainable dietary practices, and opportunities for behavioral application in the school meal setting. Future quantitative and intervention studies, including nationally representative samples, are needed before robust national priorities can be established. Full article

Background: School-based sustainable and healthy diet (SHD) interventions often inadequately capture the multidimensional nature of sustainability, with socioeconomic and cultural dimensions frequently underrepresented. While digital interventions can facilitate the integration of multiple SHD components, maintaining user engagement remains a persistent challenge that can compromise intervention effectiveness. Digital serious games represent a promising intervention strategy that can address both limitations by delivering multidimensional SHD content through interactive and engaging learning, while enabling real-time behavioral monitoring. Objectives: To assess the feasibility, as well as the acceptability and user experience of “Sustainable ePlate”, a web-based serious game for multidimensional SHD educational interventions in schools, during school-based sessions. Methods: Sustainable ePlate integrates food-level sustainability indicators into a scaffolded nine-challenge serious game. Challenges are presented through the healthy eating plate structure, while addressing eight food-level sustainability indicators transformed into 1–5 ordinal game scores. A database of 138 food items was developed from publicly available LCA and TCA databases. The game design draws on established learning theories implemented through progressive challenge sequencing, tiered feedback, and social features. Feasibility was assessed in guided school sessions in Northern Greece using the eGameFlow questionnaire and system in-app metrics. Results: The assessment sample comprised n = 59 students from two secondary schools, of whom n = 57 completed the eGameFlow questionnaire. Mean overall enjoyment was 82.54 ± 16.33%. Mean session duration was 22.39 ± 12.68 min. Across all sessions, 6003 food selections were recorded, with 5179 correct and 824 incorrect placements, corresponding to an 86.27% placement accuracy rate. In-app metrics indicated strong technical feasibility, with all sessions completing the full game sequence. Behavioral metrics demonstrated active interaction, characterized by placement interval duration, hesitation times, and high placement accuracy. Conclusions: Sustainable ePlate demonstrated feasibility and a positive user experience as a school-based serious game for multidimensional SHD education, and as a research platform for capturing in-app behavioral metrics. Further studies are required to assess its educational effectiveness in improving knowledge, attitudes, and practices related to sustainable healthy diets through pre–post design interventions. Full article

Background: Aging is a risk factor for Alzheimer’s disease and related dementias, which are associated with synaptic dysfunction and cognitive decline. Elderberry (Sambucus spp.) is rich in anthocyanins with antioxidant and anti-inflammatory properties. Docosahexaenoic acid (DHA), an essential fatty acid, plays a key role in neuronal membrane integrity during brain aging. However, it remains unclear whether elderberry and DHA exert overlapping or distinct effects on brain aging and how these relate to molecular signaling. This study aimed to characterize molecular signatures induced by dietary supplementation and to determine their relationships with behavioral outcomes. Methods: 44-week-old male C57BL/6J mice were randomly assigned to control, elderberry, DHA, or combined diets for 12 weeks. Behavioral testing assessed anxiety-like behavior, spatial learning and memory. Brain tissues underwent proteomic and phosphoproteomic profiling and fatty-acid analysis. Data were analyzed using Ingenuity Pathway Analysis to identify enriched pathways, upstream regulators, and functional associations. Results: Elderberry as well as DHA supplementation induced targeted remodeling of the proteome and phosphoproteome, with pathway enrichment involving synaptogenesis, glutamatergic signaling, and long-term potentiation. Upstream-regulator analysis predicted elderberry-associated CDK5 signaling, accompanied by reduced MAPT/Tau phosphorylation at selected sites, whereas DHA supplementation was associated with CAMK-related signaling. DHA supplementation altered fatty-acid composition, increasing the n-3/n-6 ratio. Elderberry reduced anxiety-like behavior and improved target-directed search during the Barnes maze probe test. Molecular signatures were examined in relation to the measured behavioral outcomes. Conclusions: Elderberry and DHA are associated with distinct molecular networks related to synaptic function and behavioral outcomes in the aging male mouse brain. These findings support further investigation of elderberry and DHA as dietary interventions targeting molecular and behavioral features of brain aging. Full article

Background/Objectives: Age-related eating difficulties, combined with restrictive ketogenic diet therapies (KDTs), may contribute to a narrow range of consumed foods and reduced dietary variety in children’s diet. Methods: The study aim is to compare nutritional status, food neophobia (FN), food texture preferences, and eight eating behaviors—including food fussiness (FF)—as well as meal variety and repetitiveness, between children with drug-resistant epilepsy undergoing KDT (KD group; n = 15) and healthy children (n = 100), by the Child Food Texture Preference Questionnaire, the Children’s Eating Behavior Questionnaire and the Modified Children’s Food Neophobia Scale. Results: No significant differences were found in nutritional status (percentile: weight: 53 (31.50–78.00) vs. 51.50 (35.50–71.25), p > 0.9999; height: 43 (26.5–59.5) vs. 51 (31.75–70.25), p > 0.9999; BMI: 50 (21.5–92.5) vs. 51.5 (33–69.5), p > 0.9999) and in most eating behavior domains, although both groups showed a high prevalence of feeding difficulties. The KD group showed significantly greater meal repetition (3 (2–3) vs. 2 (1–2), p = 0.0468) and lower dietary variety (3 (2–3) vs. 4 (4–4), p = 0.0004), emotional undereating (4 (4–8.5) vs. 10 (9–13), p = 0.0059) and overeating (4 (4–7) vs. 8 (6–10), p = 0.0196) scores. Within the study population, eating behaviors clustered into distinct patterns predisposing toward either an “adaptive” or a “maladaptive” approach to food. Conclusions: There is a need for an individualized approach to addressing eating difficulties in children following KDT. It seems reasonable to introduce targeted screening assessments for FN and FF to facilitate early identification of patients at risk of unfavorable eating styles. Full article

Background/Objectives: Obesity is a chronic, progressive, and relapsing disease that requires long-term, multidisciplinary management rather than episodic weight-loss treatment. Although novel incretin-based anti-obesity pharmacotherapies, including GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists, have markedly improved the clinical management of obesity, weight reduction alone does not fully capture treatment success. Body composition, lean mass preservation, physical function, nutritional adequacy, psychological well-being, adherence, and long-term weight-loss maintenance are increasingly recognized as essential therapeutic outcomes. This narrative review critically examines the role of lifestyle medicine as a co-therapeutic strategy during modern anti-obesity pharmacotherapy, with particular attention to physical activity, nutrition, behavioral support, and individualized monitoring. Methods: A narrative literature search was conducted in PubMed up to June 2026. The review included studies addressing adults with overweight or obesity and evidence related to anti-obesity pharmacotherapy, physical activity, nutrition, body composition, functional outcomes, eating behavior, quality of life, treatment tolerability, adherence, weight regain, and long-term maintenance. Results: Current evidence indicates that incretin-based therapies produce substantial and clinically meaningful weight loss, but pharmacological efficacy may be limited by reductions in lean mass, gastrointestinal adverse events, inadequate nutritional intake, treatment discontinuation, and weight regain after drug withdrawal. Physical activity should be considered a therapeutic component rather than only a tool for increasing energy expenditure, as aerobic exercise supports cardiometabolic health and cardiorespiratory fitness, while resistance training helps preserve muscle strength, bone health, and functional capacity. Nutritional strategies are equally important, particularly during appetite suppression, to maintain adequate protein, fiber, fluids, micronutrients, and diet quality. Behavioral factors, including sleep, stress, mood, stigma, self-regulation, and the food environment, may influence adherence and long-term outcomes. Conclusions: Novel anti-obesity drugs should not be viewed as replacements for lifestyle medicine but as powerful tools within an integrated chronic-care model. The goal of treatment should move beyond maximal body-weight reduction to durable improvements in body composition, metabolic health, physical function, nutritional status, quality of life, and weight-loss maintenance. Full article

Background: Self-care and healthy dietary habits are fundamental components of heart failure (HF) management, yet the relationship between dietary quality and self-care remains insufficiently explored. This study investigated the association between dietary habits and self-care behaviors among patients with HF. Methods: A cross-sectional study was conducted among 137 adults with HF attending outpatient clinics in Greece. Self-care behaviors were assessed using the Hippocratic Heart Failure Self-Care Scale (HHFSCS), and dietary quality was evaluated using the validated Greek version of the Cardiovascular Diet Questionnaire-2 (CDQ-2). Associations between demographic characteristics, dietary measures, and self-care were examined using non-parametric tests and multivariable general linear models adjusted for demographic characteristics. Results: The mean HHFSCS score was 41.0 ± 11.3, indicating a moderate level of self-care. Higher scores were observed for medication adherence and appointment keeping, whereas lower scores were observed for exercise, smoking-related behaviors, alcohol-related behaviors, and symptom monitoring. The mean total CDQ-2 score was 8.57 ± 7.17. Overall dietary quality was not significantly associated with total self-care after adjustment for age, sex, marital status, educational level, and employment status (B = −0.102, 95% CI: −0.338 to 0.134, p = 0.394). Among the dietary components, only the saturated fatty acid (SFA) score remained significantly associated with total self-care after adjustment (p = 0.015), whereas fruit and vegetable and monounsaturated fatty acid scores were not significant. Employment status was also significantly associated with self-care (p < 0.001). Conclusions: Overall dietary quality was not significantly associated with total self-care in this sample of patients with HF. However, the observed association between the SFA component and self-care suggests that specific aspects of dietary behavior may warrant further investigation. Given the cross-sectional design and reliance on self-reported measures, these findings should be interpreted cautiously and do not establish directionality or causality. Prospective studies incorporating objective dietary and behavioral measures are needed to further clarify the relationship between dietary habits and self-care in HF. Full article

Background/Objectives: Recent pediatric sleep research has increasingly adopted an integrated lifestyle perspective, examining sleep together with diet, physical activity, sedentary behavior, and family environments. However, bowel habits remain comparatively underrepresented despite their potential importance for child health. This conceptual narrative review revisits the Four Kai framework, which brings together sleep, eating, bowel habits, and physical activity as four fundamental daily physiological behaviors and explores their potential relationships with adaptive pleasure, self-regulation, and daytime functioning. Methods: This conceptual narrative review incorporated a descriptive PubMed literature-mapping exercise conducted on 16 July 2026. The search covered publications from January through June of each year from 2022 to 2026 and focused on studies in which sleep was a principal research topic together with terms related to diet, bowel function, physical activity, and lifestyle. Publications clearly outside pediatric or adolescent populations were excluded. Titles and abstracts were reviewed, with full texts consulted when necessary, and eligible studies were classified thematically according to their principal research objective. This exercise was intended to provide descriptive context for the conceptual review and was not conducted as a systematic or scoping review. Results: The descriptive mapping and narrative synthesis indicate that pediatric sleep research frequently examines sleep in relation to diet, physical activity, sedentary behavior, family environments, and other lifestyle factors, whereas everyday bowel habits remain comparatively underrepresented. The reviewed literature supports multiple individual and pairwise associations among sleep, eating, physical activity, bowel function, and daytime functioning but does not establish that these four behaviors operate as a single integrated physiological system. Direct empirical evidence for a pathway linking the Four Kai through adaptive pleasure and positive self-regulation to daytime functioning is currently lacking. Conclusions: The Four Kai framework is best regarded as a hypothesis-generating conceptual framework rather than an established biological or causal model. Its potential value lies in bringing sleep, eating, bowel habits, and physical activity into a common perspective and generating testable questions about their possible functional integration. Future longitudinal and intervention studies should evaluate these behaviors together with adaptive pleasure, self-regulation, and daytime functioning to determine which proposed relationships can be empirically supported. Full article

Obesity is a complex, multifactorial chronic disease characterized by excessive and/or aberrant adiposity that requires interventions beyond conventional calorie-restriction models. Current clinical guidelines converge on behavioral modification, encompassing nutritional therapy, physical activity, stress reduction, and sleep improvement, as the cornerstone of obesity management, with psychological therapy, pharmacotherapy, and bariatric procedures as adjunctive or escalating options. While traditional “one-size-fits-all” dietary approaches frequently yield suboptimal long-term outcomes, precision nutrition has emerged as a promising strategy for individualized obesity care. This review critically appraises the evidence underlying each pillar of precision nutrition: genetic profiling shows clear utility in monogenic obesity but variable benefit when diet is matched to common polygenic variants; microbiome-targeted studies reveal that the Bacillota to Bacteroidota ratio shows inconsistent associations with obesity across studies, with genus-level and functional alterations offering more reproducible targets; and metabolomic profiling of postprandial glycemic responses has progressed from foundational predictive algorithms to large-scale clinical validation. It also highlights chrono-nutrition, the alignment of food timing with individual chronotype, as an emerging pillar of personalization. Beyond dietary composition, the review addresses how personalized nutrition can mitigate the adverse effects of incretin-based pharmacotherapy and discusses how artificial intelligence can integrate multi-omics and behavioral data into real-time dietary guidance. Future clinical implementation will require overcoming challenges related to data integration, predictive accuracy, and accessibility, paving the way for more effective, evidence-based obesity management. Full article

Mate choice can vary with internal condition, but whether gut microbial variation is associated with female mate-choice-related olfactory preferences remains poorly understood. In this study, we tested whether dietary dried yeast supplementation was associated with changes in gut microbiota and odor preference in captive female giant pandas (Ailuropoda melanoleuca). Females in the dried yeast supplementation group received 10 g of dried yeast tablets daily for five consecutive days, while control females received the same diet without supplementation. Female olfactory preferences for urine from adult and senile males were assessed using odor preference tests before and after supplementation, and fecal samples were analyzed to characterize gut bacterial communities. Dried yeast supplementation altered the relative abundances of several gut bacterial taxa. Putatively beneficial taxa, including Muribaculaceae and Weissella cibaria, increased, whereas potentially pathogenic or opportunistic taxa, including Enterobacteriaceae and Campylobacter, decreased (all adjusted p < 0.05). Before supplementation, females showed no significant preference between adult and senile male urine. After supplementation, females showed a significant preference for adult male urine. Several gut bacterial genera were significantly associated with female exploratory behavior. These results suggest a possible association between dried yeast supplementation, gut microbial shifts, and female olfactory responses to male urinary cues. Full article

Background/Objectives: Dietary inflammation may influence cardiometabolic health, yet the gut mycobiome and bacterial–fungal interactions remain unclear. Building upon our earlier findings and data from the TALENTs trial (Targeting Aging and Longevity with Exogenous Nucleotides) baseline data, we explored gut fungal profiles and bacterial–fungal co-occurrence patterns in relation to the Dietary Inflammatory Index (DII) and Life’s Essential 8 (LE8) in older adults. Methods: We enrolled 301 community residents aged 60–70 years, with 285 providing qualified fungal internal transcribed spacer (ITS) sequencing data. DII scores were derived from 3-day dietary records to reflect dietary inflammatory risk, and LE8 (integrating health behaviors including physical activity and metabolic health factors including BMI, blood lipids, blood pressure, and blood glucose) was used to assess cardiovascular health; LE8_non-diet was applied as a sensitivity measure. Fungal diversity, genus-level taxa, ecological guilds, and bacterial–fungal associations were analyzed using diversity indices, ZINB/Hurdle models, bootstrap, E-values, DIABLO analysis, and network construction. Results: DII showed an inverse correlation with LE8_non-diet (r = −0.130, p = 0.024). Fungal alpha and beta diversity did not differ significantly across DII-defined groups. Conversely, better cardiovascular status was linked to higher fungal richness, with significantly elevated Chao1 and ACE indices in the high-CVH group (both p < 0.05). Additionally, integrated ZINB, Hurdle, and stability analyses jointly pinpointed four candidate fungal genera that correlated with both DII and LE8. Both ZINB and DIABLO analyses consistently indicated that antagonistic interactions dominated gut bacterial–fungal associations (89.9% vs. 63.8% of negative associations, respectively), with DIABLO further revealing synchronized community-level co-variation between the two kingdoms (r = 0.325, p < 0.01). FUNGuild prediction further revealed saprotrophic guilds enriched in the high-CVH group and host-associated guilds in the low-CVH group, with similar patterns across DII-defined groups. Conclusions: This cross-sectional study reveals gut mycobiome profiles and potential bacterial–fungal co-occurrence patterns among older adults stratified by dietary inflammatory potential and cardiovascular health status, generating testable hypotheses for subsequent nutritional and metabolic research integrating lifestyle behaviors and functional health outcomes. Full article

Background/Objectives: Individuals with attention-deficit/hyperactivity disorder (ADHD) often experience communication difficulties (CDs), including challenges with language development, pragmatic communication, and speech processing. While these difficulties are typically associated with cognitive and behavioral symptoms; emerging research suggests that biological and nutritional factors may also contribute. This narrative review aims to explore how diet patterns, gut microbiome changes and oxidative stress might be associated with communication difficulties in ADHD. Methods: This review was performed using the SANRA (Scale for the Assessment of Narrative Review Articles) framework. A structured/comprehensive literature search was performed across major databases including PubMed, Scopus and Web of Science. Google Scholar has been utilized as a complementary database to support emerging studies that have not yet been registered in these databases. The search focused on studies that investigated the connections between nutrition, microbiome dysregulation, oxidative stress, ADHD and communication-related outcomes. Results: Current research indicates that unbalanced diets, micronutrient deficiencies, and changes in the gut microbiome can lead to neuroinflammation and oxidative stress. All these biological processes may disrupt neurotransmission and neural connectivity, which can potentially affect brain regions and networks that are highly important for attention and language processing, including both cortical and subcortical structures. Therefore, communication difficulties in ADHD may, in part, stem from these interconnected neurobiological mechanisms. However, direct clinical evidence linking nutritional factors, gut microbiome alterations, or oxidative stress with communication-specific outcomes in ADHD remains very limited, as most available studies have focused on core ADHD symptoms, attention, executive functioning, or biological markers. Conclusions: Dietary factors, alterations in the gut microbiome, and oxidative stress may collectively contribute to the complex underlying causes of communication disorders in ADHD. This review proposes an integrative framework that links nutrition-related mechanisms to communication outcomes, emphasizing the potential impact of modifiable lifestyle factors. Further longitudinal studies are needed to establish causal relationships and determine the clinical effectiveness of targeted nutritional interventions for communication difficulties in ADHD. Full article

Objective: The long-term management of cardiovascular diseases (CVDs) requires comprehensive rehabilitation strategies aimed at optimizing functional recovery and promoting behavioral changes. These interventions may include digital technologies that emerged as promising approaches to facilitate lifestyle changes, such as dietary behavior and physical activity (PA). Aim: This review aimed to synthesize the current evidence for the potential impact of remotely delivered nutrition interventions with or without a combination of PA interventions on biochemical biomarkers, cardiovascular indexes, anthropometric parameters, levels of PA, exercise and functional capacity, adherence to the Mediterranean Diet (MD), diet quality and quality of life, rehospitalization, urgent visits, death and acute events in adults (≥18 years) with CVDs. Secondary outcomes were accessibility, safety, usability, and adherence. Methods: The PubMed, Web of Science, and Scopus databases were comprehensively searched up to 2026 for Randomized Controlled Trials (RCTs) published in English, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The methodological quality was assessed using the revised Cochrane Risk of bias tool for RCTs (RoB2). Results: 11 RCTs met the inclusion criteria. Sample sizes ranged from 66 to 879 participants. The duration of the interventions varied from 4 weeks to 12 months. The interventions were delivered remotely using a range of digital health technologies, including web-based programs, mobile phones, wearable devices, smartphone applications, and mini-apps. Favorable changes were observed in diet quality and in adherence to MD and PA levels, with no intervention-related adverse events reported. The RoB2 assessment indicated that the majority of included studies (6 out of 11) were classified as having some concerns regarding risk of bias. Conclusions: Remotely combined nutrition and PA interventions are a feasible and effective approach for improving mainly patient-reported outcomes in adults with CVDs. These findings support integrating remote multimodal rehabilitation into routine cardiovascular care and highlight the potential of telehealth-based models to enhance patients’ access to rehabilitation services. Full article