Search Results (682)

Contemporary health cultures increasingly promote disciplined eating and bodily optimisation, contributing to growing interest in orthorexia nervosa (ON), a pattern of restrictive eating characterised by an obsessive focus on food purity and health. While ON has been widely studied in relation to dietary restriction and health anxiety, less attention has been given to how individuals themselves construct meaning around these practices. The present qualitative study aimed to explore how individuals displaying orthorexic tendencies construct moral identity and self-worth through their dietary practices. Eighteen participants (13 women, 5 men; aged 19–58) living in the United Kingdom who self-identified as “healthy eaters” took part in semi-structured interviews. Data were analysed using reflexive thematic analysis within a social constructionist framework. Four themes were generated: (1) The Disciplined Self, describing how strict dietary practices were framed as evidence of personal control and self-regulation; (2) The Body as Evidence of Purity and Health, where physical appearance and bodily feelings were interpreted as confirmation of moral and dietary correctness; (3) Ethical Eating and Moral Positioning, illustrating how participants positioned their food choices as ethically superior; and (4) Guilt and Moral Repositioning, highlighting the moral emotions that followed perceived dietary transgressions. These findings suggest that orthorexic eating practices function not only as health behaviours but also as moral performances through which individuals construct disciplined, responsible, and virtuous identities. Understanding these moral and identity dimensions may help situate orthorexic tendencies within broader sociocultural narratives surrounding health, morality, and self-discipline. Full article

Background: Childhood obesity remains a major public health challenge worldwide, with increasing prevalence across Europe. Schools represent an important setting for promoting healthy lifestyles through physical activity and nutrition-related interventions. This systematic review aimed to evaluate the effectiveness of school-based interventions promoting physical activity and healthy eating behaviours among children and adolescents aged 6–18 years in European countries. Methods: A systematic literature review was conducted using PubMed and Scopus. Studies were eligible if they were conducted in school settings, targeted children and adolescents aged 6–18 years, were implemented in European countries, had a minimum duration of nine months, and assessed anthropometric and/or behavioural outcomes related to obesity prevention. Methodological quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Results: Sixteen studies conducted across nine European countries met the inclusion criteria. Intervention duration ranged from nine months to five years, and most studies employed multicomponent approaches combining physical activity promotion, nutrition education, environmental modifications, and parental involvement. Seven studies were rated as strong quality, six as moderate quality, and three as weak quality. Among the fourteen studies assessing BMI or other anthropometric outcomes, eleven (78.6%) reported statistically significant improvements in at least one obesity-related measure, including BMI, BMI z-score, waist circumference, waist-to-height ratio, body fat percentage, or overweight/obesity prevalence. Evidence regarding physical activity and nutrition-related outcomes was more heterogeneous, although several studies reported improvements in dietary behaviours, nutrition knowledge, sedentary behaviour, and physical activity levels. Positive anthropometric effects were more commonly observed in interventions lasting at least one academic year and in multicomponent programmes. Some studies also reported differential effects according to sex and parental educational background. Conclusions: The findings of this review suggest that long-term, multicomponent school-based interventions can contribute to improving obesity-related anthropometric outcomes among children and adolescents in European countries. However, evidence regarding sustained changes in physical activity and dietary behaviours remains less consistent. Future research should focus on identifying the most effective intervention components and strategies for achieving long-term behavioural change across diverse populations and educational contexts. Full article

Background/Objectives: Obesity remains a global health concern, and personalized prevention strategies that consider genetic predispositions can enhance existing strategies. Research suggests that variation in circadian rhythm-related genes, or clock genes, may influence obesity risk, in part through effects on dietary behaviour. However, associations between single-nucleotide polymorphisms (SNPs) in clock genes and dietary outcomes remain understudied, particularly in children. Therefore, we investigated cross-sectional associations between clock gene SNPs and dietary outcomes using baseline data from 226 adults (138 females, 88 males) aged 26–50 y and 168 children (90 females, 78 males) aged 2–6 y from the Guelph Family Health Study. Methods: DNA was extracted from saliva and genotyped using the Illumina Global Diversity Array, and dietary intake was assessed using the Automated Self-Administered 24 h Dietary Assessment Tool. Nine SNPs representing 8 clock genes were selected based on prior associations with dietary and obesity-related outcomes. Generalized Estimating Equations were used to test associations, adjusted for multiple comparisons with the Benjamini–Hochberg false discovery rate (FDR) procedure. Results: Ten nominal associations were identified (p < 0.05), and 2 remained significant after FDR correction (P_adj < 0.05); among children, rs2314339-T (NR1D1) was associated with a lower percentage of energy from protein (β = −2.4%, P_adj = 0.003) and rs11605924-A (CRY2) with higher energy intake (β = 118.0 kcal, P_adj = 0.044). Conclusions: Findings suggest that clock gene SNPs may influence dietary habits from early childhood. Future longitudinal and functional studies are needed to clarify whether these variants can inform precision nutrition strategies for obesity prevention. Full article

Background: Modifiable lifestyle factors may contribute additively to colorectal cancer (CRC) risk in individuals who already have non-modifiable risk factors, such as prior colorectal neoplasia or significant family history of CRC. However, the impact of multicomponent lifestyle interventions (such as dietary modification, physical activity, and counselling) on behavioural modification, risk of colorectal neoplasia, and quality of life (QoL) in this population has not yet been systematically reviewed. Aims: The primary aim was behavioural change (change in body weight, diet, physical activity, sedentary lifestyle, smoking, and alcohol consumption). The secondary aim was colorectal neoplasia outcomes, including the incidence of precancerous lesions and/or cancer and CRC mortality/survival, and QoL, including specific domains. Methods: This review was conducted following the Cochrane guidelines for Systematic Reviews of Interventions. Both randomised and non-randomised studies assessing the effect of multicomponent lifestyle interventions on behavioural modification, risk of colorectal neoplasia, mortality, and quality of life in people at above-average risk of CRC were included. Medline/Ovid, Cochrane Library, Web of Science, and Scopus were searched. Screening, data extraction, and risk of bias assessment were independently performed by two reviewers using the revised Cochrane Risk of Bias (RoB) tools. Results: Of the 4174 studies screened, 10 interventional studies were eligible for inclusion, which had outcomes for behavioural change or quality of life. No interventions assessed neoplasia risk or mortality outcomes. Multicomponent lifestyle interventions mainly targeting diet and physical activity, delivered via a telephone-based or health coaching approach, showed positive effects on healthy behaviours and quality of life compared with usual care, although some studies reported inconsistent results. Conclusions: There is emerging evidence that multicomponent lifestyle interventions may offer beneficial effects on practicing healthy behaviours and improving QoL for individuals at above-average risk for CRC and undergoing colonoscopy surveillance. Full article

Sustainable dietary transitions are increasingly recognised as essential for addressing the interconnected challenges of public health, environmental degradation and food system sustainability. Although the Mediterranean Diet (MD) is widely acknowledged as a healthy and sustainable dietary model, adherence has progressively declined across diverse populations. This study develops an integrated conceptual framework to explain the sustainable adoption of the Mediterranean Diet, with particular emphasis on the conceptual mediating role of plant-based foods. A structured conceptual narrative review was conducted using interdisciplinary evidence from nutrition science, sustainability research, behavioural sciences and food policy. The proposed framework integrates individual capacities, socio-cultural contexts, structural environments and ecological awareness within a systems-oriented perspective. The findings suggest that dietary behaviour is shaped by dynamic and context-dependent interactions influenced by feedback mechanisms, life-course transitions and structural constraints. Within this framework, plant-based foods function as integrative leverage points linking health, environmental and cultural dimensions. The study highlights the limitations of individual-centred approaches and emphasises the importance of coordinated multi-level strategies to support sustainable dietary transitions. Overall, the framework provides a theoretically grounded basis for future research, policy development and integrated interventions aimed at promoting resilient and sustainable food systems. Full article

Evidence on the interplay between perceived stress, dietary behaviour, and weight-related psychosocial burden in Romanian young adults remains scarce. This cross-sectional study assessed associations between BMI, perceived stress, multi-system somatic symptom severity, and psychosocial burden in 117 participants aged 16 to 20 years (89.7% female; mean age 19.23 ± 0.74 years; mean BMI 22.66 ± 3.85 kg/m²), recruited by convenience sampling in Târgu Mureș, Romania, during June 2025. Non-parametric methods were used throughout. Female participants scored significantly higher than males across digestive (p < 0.001), neurological (p = 0.001), cutaneous (p = 0.014), and total symptom domains (p < 0.001), with a median total symptom score of 21.0 versus 3.0 in males. Perceived stress correlated positively with neurological (rS = 0.445), cardiovascular (rS = 0.350), digestive (rS = 0.316), and total symptom scores (rS = 0.401; all p < 0.001). BMI was not associated with somatic symptoms but correlated with weight-related stigma (rS = 0.391, p < 0.001). Emotional distress was prevalent regardless of weight status: 60.7% reported food-related guilt and 59.8% reduced self-confidence, yet only 6.0% had consulted a mental health professional. Stress management, nutritional counselling, and body image support should target young adults across all BMI categories. Full article

Background: Dietary behaviours in young athletes are shaped by multiple behavioural, social, and environmental influences, which may contribute to the coexistence of healthy and unhealthy eating patterns. This study aimed to explore factors associated with fast-food consumption frequency and adherence to the Mediterranean diet (MD) among young football athletes. Methods: A cross-sectional study was conducted among 94 male football players aged 10–16 years from a Portuguese football club. Adherence to the MD was assessed using the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) index. Fast-food consumption patterns and food-choice motivations were evaluated through a structured questionnaire. Anthropometric measurements were obtained using standardised procedures. Correlation, linear regression, and ordinal regression analyses were performed. Results: Most participants demonstrated high adherence to the MD (96.8%), with a median KIDMED score of 12.0 (IQR: 10.0–13.0). Although 88.3% of participants reported consuming fast food, intake frequency was generally low, with 67.0% reporting consumption never or only once per month. Higher fast-food consumption frequency was associated with lower fruit and vegetable intake and higher consumption of sweets and pastries. No significant associations were observed between fast-food consumption frequency and overall MD adherence, Body Mass Index z-score, or fat mass percentage. Higher health-related motivation scores were associated with lower odds of more frequent fast-food consumption (OR = 0.248; p = 0.021), whereas greater decision autonomy regarding restaurant choice was associated with higher consumption frequency (OR = 4.036; p = 0.010). Conclusions: Young football athletes showed high adherence to the Mediterranean diet despite the presence of fast-food consumption, suggesting that healthy and unhealthy dietary behaviours may coexist within the same population. Behavioural factors, particularly health motivations and food-choice autonomy, appear to influence fast-food consumption independently of overall diet quality and anthropometric status. Full article

Background/objective: This study determined the prevalence of dietary behaviours and examined their relationship with nutritional status among Malaysian school-based adolescents. Methods: Data from 33,523 adolescents who participated in the Adolescent Health Survey (AHS 2022) were analysed. Multiple logistic regression was employed to assess associations between dietary behaviours and nutritional status, adjusting for potential confounders. Results: Our findings demonstrated a double burden of malnutrition, with 6.8% stunting, 8.3% thinness, and 30.5% overweight/obese. High prevalence of inadequate daily intake of fruit and vegetables (FV) (83.9%) and insufficient daily dairy consumption (62.7%) was observed. Approximately one-third of adolescents reported frequent fast-food consumption (i.e., at least one day per week) (35.4%) and daily intake of carbonated soft drinks (32.4%). Daily carbonated soft drink consumption was associated with higher odds of overweight/obesity (aOR:1.11; 95% CI:1.04–1.20), highlighting the need to prioritise the public health strategies aimed at reducing sugar intake. Conversely, inadequate FV intake (aOR:0.88; 95% CI:0.81–0.95) and frequent fast-food consumption (aOR:0.87; 95% CI:0.82–0.94) were associated with lower odds of overweight/obesity, while insufficient daily dairy intake was associated with lower odds of thinness (aOR:0.83; 95% CI:0.73–0.94). These negative associations should be interpreted cautiously due to possible reverse causality and reporting bias. Conclusions: The findings highlight the importance of strengthening nutrition education and the food environment among Malaysian adolescents. Full article

This paper describes the development and design of Nutrition for Athletes: A Focus on Dietary Supplements, an online educational intervention created for varsity athletes at the University of Guelph. Guided by the Theory of Planned Behaviour (TPB), the program aimed to improve athletes’ nutrition and dietary supplement-related knowledge while modifying attitudes, subjective norms, perceived behavioral control, intentions, and behaviors associated with dietary supplement use. Formative research with the target population revealed widespread misconceptions, strong social influences, and high perceived benefits of supplement use, which highlighted the need for an intervention focused on reshaping underlying beliefs. The program covered topics related to sports nutrition, hydration, dietary supplements, and risks of supplement use, and was integrated into the university’s learning management system. Each unit was mapped onto relevant TPB constructs, with an emphasis on correcting inaccurate beliefs and promoting a food-first approach. The program’s effectiveness was evaluated through pre- and post-intervention questionnaires assessing knowledge and TPB constructs. This paper outlines the theoretical framework, development process, and content structure of the intervention, and presents a model that can be replicated in future educational programs. Full article

Background/objectives: Obesity is a multifactorial condition influenced by interactions between genetic susceptibility and environmental factors. The fat mass and obesity-associated (FTO) gene has been widely linked to obesity risk, particularly the rs9939609 polymorphism, which is associated with higher body mass index (BMI) and adiposity. However, evidence in adolescents remains inconsistent, and lifestyle factors such as physical activity and diet may modify genetic risk. The objectives of this study were: (i) to examine the influence of environmental, genetic, physical activity, and dietary factors on the BMI and overweight-related variables of adolescents, and (ii) to assess the impact of the rs9939609 polymorphism in the FTO gene on these variables. Methods: A cross-sectional study was conducted involving 206 adolescents aged 12 to 16 years. Body mass index (BMI), physical fitness, physical activity levels, adherence to the Mediterranean diet, mobile phone usage, and FTO rs9939609 genotyping from buccal swabs were collected. Results: No significant associations were found between the FTO genotype and BMI, or with physical activity, mobile phone usage and dietary habits. Boys showed higher physical fitness and physical activity levels than girls (p < 0.05). The only factor significantly associated with BMI was regular breakfast consumption: adolescents who habitually ate breakfast had a lower prevalence of overweight (χ² = 7.98, p = 0.005). Conclusions: The rs9939609 polymorphism in the FTO gene was not associated with overweight in this adolescent cohort. The findings underscore the relevance of healthy behaviours, particularly regular breakfast consumption and physical activity, especially among boys, as factors potentially associated with lower prevalence of overweight during adolescence. Full article

Background: Birth defects remain a major global public health concern, particularly in low-resource settings where awareness and preventive practices are limited. Maternal knowledge, attitudes, and practices (KAP) are critical in the prevention and management of birth defects. This study explored contextual factors influencing maternal KAP using a mixed-methods approach in three rural districts of the Eastern Cape, South Africa. Methods: A convergent mixed-methods cross-sectional study was conducted among 72 mothers selected through purposive sampling. Quantitative data were collected using a structured questionnaire administered in English only, covering socio-demographic characteristics, obstetric history, knowledge, and preventive practices. Qualitative data were obtained through interviews exploring beliefs, perceptions, and cultural explanations of birth defects. Quantitative data were analysed using descriptive statistics and linear regression analysis to identify factors associated with birth defects, while qualitative data were thematically analysed to provide contextual understanding. Results: Most participants resided in the Amathole district (63.89%), followed by Alfred Nzo (18.06%) and Joe Gqabi (18.06%). Most women were aged between 20 and 35 years (52.78%), while 15.28% were younger than 20 years and 6.94% were older than 45 years. Over half of the respondents were single (55.56%), 34.72% were married, and the remainder were either separated (4.17%) or divorced (5.56%). Numerous participants had primary education (56; 77.78%), followed by secondary (11; 15.28%) and tertiary education (5; 6.94%). The majority were unemployed (56; 77.78%), while smaller proportions were employed (10; 13.89%) or engaged in other income-generating activities (6; 8.33%), indicating limited participation in formal employment among respondents. Nearly all participants (95.83%) had experienced pregnancy, with 70.83% reporting pregnancy-related complications. Only 2.78% reported having a child with a birth defect, while 90.28% reported a family history of birth defects. Knowledge of genetic causes was relatively high (69.23%), but awareness of modifiable risk factors was limited. Although 93.06% recognized alcohol use during pregnancy as harmful, fewer participants identified smoking or medication use (18.06%) and advanced maternal age (26.39%) as risk factors. Only 13.89% acknowledged the preventive role of antenatal care. Qualitative findings revealed strong cultural influence on perceptions of birth defects, with causes attributed to medical factors (38.89%), supernatural beliefs such as witchcraft or curses (18.06%), immoral behaviour (12.50%), and dietary taboos (11.11%). Traditional health-seeking behaviour was common, with 91.67% consulting traditional healers during pregnancy. Linear regression analysis identified significant predictors of birth defects, including family history (β = 1.36, p = 0.008), alcohol use during pregnancy (β = 1.13, p = 0.050), and inadequate antenatal care attendance (β = 0.99, p = 0.040). Advanced maternal age showed a weaker and non-significant association (β = 0.79, p = 0.080). Conclusions: The study highlights substantial gaps in maternal knowledge and the strong influence of cultural beliefs on birth defect prevention. Strengthening culturally sensitive health education, improving antenatal care services, and engaging traditional healers in community-based interventions are essential to improve maternal health outcomes in rural South Africa. Full article

Dietary fibre deficiency remains a global nutritional concern, and the development of fibre-enriched functional foods is increasingly important. Fruit processing by-products, such as pomelo (Citrus maxima) peel, represent a sustainable source of dietary fibre with potential techno-functional applications. In this study, a fibre-enriched chewable tablet was developed using pomelo (Citrus maxima) peel fibre (CPF) as a functional ingredient and structural matrix. The formulation was prepared through direct compression and systematically evaluated in terms of powder flow behaviour, structural characteristics (FTIR, XRD, and SEM), hydration-related functionality, and tablet quality attributes. The CPF-based powder blend exhibited good flowability and compressibility, with an angle of repose of 26.62°, Carr’s index of 8.9%, and a Hausner ratio of 1.22, indicating suitability for tablet processing. Structural characterisation demonstrated the formation of a semi-crystalline matrix with a porous fibrous morphology. CPF incorporation significantly improved water-holding capacity (9.84 g/g) and oil-holding capacity (2.97 g/g), indicating enhanced hydration functionality. The developed tablets exhibited uniform weight (560 ± 9.5 mg), consistent dimensions, and acceptable disintegration behaviour (168 ± 15 s), demonstrating satisfactory physical quality. Overall, these findings suggest that pomelo peel fibre can be effectively utilised in chewable delivery systems, providing a feasible strategy for the valorisation of citrus by-products in functional food applications. Full article

Background/Objectives: Diet quality indices (DQIs) are commonly used to evaluate the alignment of dietary intake with national dietary guidelines. However, few methods have been developed to apply DQIs to image-based dietary assessment tools. This study aimed to develop a novel food-based Diet Quality Score (DQS) and examine its construct validity in Australian adults aged 18–65 years living with a higher weight (BMI 30–45 kg/m²), using the validated Healthy Eating Index for Australians 2013 (HEIFA-2013) for comparison. Methods: This cross-sectional study assessed dietary intake in 260 adults (mean age 48 ± 12 years; BMI 35.0 ± 4.2) collected over 4 days using the mobile Food Record (mFR™) and scored using the HEIFA-2013 and DQS (both scored out of 100). Descriptive statistics summarised participant characteristics with DQS and HEIFA-2013 scores. Construct validity was examined by assessing the associations between sociodemographic, health behaviour, anthropometric, and clinical blood marker variables and DQS and HEIFA-2013 scores. Multivariable binary logistic regression identified variables associated with being in the lowest diet quality tertile for both DQIs. Results: The mean scores were 47.4 ± 8.7 for the DQS and 52.0 ± 8.6 for HEIFA-2013. Both scores were positively associated with age (DQS: r = 0.216, p < 0.001; HEIFA-2013: r = 0.265, p < 0.001) and attention paid to the health aspects of their diet (DQS: p < 0.023; HEIFA-2013: p < 0.010). Increasing age (OR = 0.958, 95% CI: 0.932–0.985, p = 0.003) and moderate versus low physical activity (OR = 0.40, 95% CI: 0.21–0.80, p = 0.009) decreased odds of being in the lowest diet quality tertile for both DQI scores. Conclusions: The DQS demonstrated acceptable construct validity, providing a valid method for using image-based dietary assessments to evaluate diet quality in Australian populations. Full article

Food allergy is a chronic immune-mediated condition that must be understood not only as a biological disorder but also as a biopsychosocial condition with significant psychological and neurodevelopmental consequences. Beyond the management of acute allergic reactions, individuals living with food allergy experience ongoing threat appraisal, dietary restriction, and social constraints, shaping emotional regulation, cognition, and wellbeing. This review adopts a psychology-led biopsychosocial and neuropsychological framework to examine the mechanisms through which immune activation and food avoidance influence psychological functioning. Drawing on medical psychology, psychoneuroimmunology, and gut–brain research, we explore how threat perception, interoceptive awareness, learning processes, stress physiology, and family context interact to shape emotional and behavioural responses to food allergy. Particular attention is given to the role of risk perception, vigilance, and learned avoidance in driving anxiety and reduced quality of life. By integrating evidence across psychological and biological domains, this review argues for a more comprehensive model of food allergy that recognises the cumulative emotional and neuropsychological burden associated with living with chronic dietary risk. Greater integration of psychological perspectives within allergy care may help support adaptive coping, reduce unnecessary restriction, and improve quality-of-life outcomes for individuals and families affected by food allergy. Full article

Background: The incidence of early-onset colorectal cancer (EOCRC) is rising globally, yet its underlying risk factors remain incompletely understood, particularly in cases without recognised hereditary syndromes. Objectives: To update and synthesise the current body of evidence on modifiable and non-modifiable risk factors for sporadic early-onset colorectal cancer. Methods: A systematic review of peer-reviewed articles published in English reporting original observational research examining risk factors for sporadic early-onset colorectal cancer (<50 years old) was conducted. PubMed and EMBASE databases were searched from inception to March 2025. Across studies, effect measures varied; therefore, the synthesis focused on the consistency of associations rather than the direct comparison of effect sizes. Results: The initial search identified 2575 papers; 34 studies were included after screening. Several consistent associations were identified, with dietary and lifestyle factors along with metabolic conditions emerging as key risk factors. EOCRC risk was higher in males (adjusted odds ratio (aOR) 1.36–2.21 across studies), individuals of Caucasian ethnicity (aORs 1.48–2.56), and in individuals whose age was approaching 50 years (per year, aORs 1.05–1.11). Putatively sporadic EOCRC was associated with a family history of CRC or other cancers (aORs up to 8.61). Other key factors linked to higher risk included obesity (aORs 1.92–2.88; adjusted Hazard Ratios (aHRs) 1.04–1.82), metabolic syndrome (aORs 1.25–2.48; aHRs 1.2–1.26), diabetes (aORs 1.24–3.42), Western dietary patterns (aORs 1.84–2.99), and sedentary behaviours (adjusted relative risks (aRR) 1.69–2.44). Moderate-to-vigorous exercise appeared protective (aORs 0.34–0.58), as did higher vitamin D levels (aHRs 0.41–0.61). Evidence for smoking, alcohol, medications and early/in utero environmental exposures was inconsistent. Conclusions: Lifestyle and metabolic factors, including Western dietary patterns, obesity and sedentary behaviours, were associated with sporadic EOCRC. Family history also emerged as a significant contributor to putatively sporadic disease, suggesting heritable influences beyond recognised syndromes and interplay between environmental factors and genetic predisposition. Future research should focus on integrated tumour and germline profiling, including broader genomic analyses in well-characterised cohorts, to better understand potential pathogenic mechanisms and support the development of risk stratification approaches. Full article