Search Results (7,317)

Background/Objectives: People with HIV (PWH) remain at high risk for cardiovascular and metabolic complications despite effective antiretroviral therapy (ART). Diet quality is an important modifiable factor that may influence these complications. Diets high in ultra-processed foods (UPF) have been linked to adverse metabolic and inflammatory profiles in the general population, but their impact on PWH remains poorly understood. The NOVA 4 classification categorizes foods by degree of processing, from unprocessed/minimally processed (NOVA 1) to UPF (NOVA 4). Methods: We conducted a cross-sectional study of adults with virologically suppressed HIV on stable ART. Assessments included dietary intake consisting of 24 h recalls analyzed with Nutrition Data System for Research software (NDSR) and classified into NOVA categories by a registered dietitian and the following characteristics: body composition (total and regional fat by DEXA and CT scan abdomen), cardiometabolic variables (glucose, HbA1C, HOMA-IR, lipids, blood pressure), and biomarkers of inflammation, immune activation, and gut integrity quantified by ELISA. Patients were stratified into NOVA 4 groups based on the median and quartile proportions of total energy intake from NOVA 4 foods. Associations between dietary NOVA and outcomes were analyzed using generalized additive models (GAMs) adjusted for age, sex, race, and CD4 count. Results: Among 222 PWH (mean age 45.4 ± 14.2 years; 31% female; 66% non-white; BMI 30.61 ± 7.91 kg/m²), median NOVA 4 intake was 45.6% of total energy intake. Participants with higher vs. lower NOVA 4 intake showed differences in diet quality, but in GAMs, higher NOVA 4 intake was not associated with higher levels of inflammatory, cardiometabolic, gut integrity, and body composition variables. Conclusions: In PWH, UPF consumption was high but not associated with markers of cardiometabolic health, systemic inflammation, or gut integrity. This may reflect the multifactorial nature of the heightened inflammation in PWH, potentially obscuring the effect of diet. Full article

Background/Objectives: Knowledge of plant-based diets is gaining increasing significance in adolescents due to the growing popularity of vegetarian and vegan dietary patterns. To date, there has been limited research examining the level of awareness and understanding of these diets among secondary school students, as well as the factors influencing their knowledge. The aim of the study was to determine the prevalence of plant-based diets and to assess knowledge regarding these dietary patterns among high school students, as well as to identify factors associated with both diet adherence and achieving sufficient nutritional knowledge. Methods: A cross-sectional study was conducted among 341 high school students. Data were collected using a self-administered paper questionnaire that included demographic information, self-reported body weight and height, adherence to plant-based diets, and knowledge of vegetarian and vegan nutrition. Nutritional knowledge was assessed using a structured 19-item questionnaire (25 scorable items) and verified for reliability (test–retest, Krippendorff’s alpha = 0.88). Based on a 25-point scale, a score of >60% (16–25 points) was categorized as ‘sufficient’ knowledge. Statistical analyses included the chi-square test, Mann–Whitney and Kruskal–Wallis non-parametric tests, and multivariable logistic regression to estimate adjusted odds ratios (aOR) for factors associated with sufficient knowledge. Results: The prevalence of plant-based diets in the study group was 16.1% (n = 55), with a significantly higher frequency observed among female students and those with sufficient nutritional knowledge. The majority of students (81.2%) achieved sufficient knowledge. Higher scores were observed among female students, those in higher grade levels, and those individuals adhering to plant-based diets (p < 0.05). Multivariate regression analysis indicated that male sex (aOR = 0.38 compared to females), higher grade level (aOR = 3.66 for grade 3 vs. grade 1; aOR = 3.62 for grade 4 vs. grade 1), residence in a rural area (aOR = 0.50), and non-adherence to a plant-based diet (aOR = 0.32) were independently associated with sufficient knowledge. Conclusions: The majority of high school students demonstrate sufficient knowledge regarding plant-based diets, with significant variations associated with sex, grade level, place of residence, and experience with plant-based diets. These findings underscore the need for targeted educational interventions, particularly among male students, those in lower grade levels, and individuals residing in rural areas. Full article

Background: Undernutrition among children under five years remains a major public health challenge, particularly in low- and middle-income countries and rural communities where poverty, food insecurity, and limited access to health services persist. Maternal and caregiver perceptions play a critical role in shaping feeding practices and health-seeking behaviours that influence child nutritional outcomes. Objective: This study explored mothers’ and caregivers’ perceptions of factors contributing to undernutrition among children under five years in a rural community of Ngqeleni, Eastern Cape, South Africa. Methods: A qualitative descriptive study was conducted at a primary healthcare clinic in the Ngqeleni sub-district. Purposive sampling was used to recruit mothers and caregivers of children under five years. Data were collected through seven in-depth interviews and three focus group discussions involving a total of 25 participants. Interviews were conducted using a semi-structured guide and analyzed thematically. Results: Five major themes emerged: caregivers’ perceptions of nutrition, household food insecurity and unemployment, limited dietary diversity, culturally influenced feeding practices, and gaps in practical nutrition knowledge. Caregivers demonstrated concern for child nutrition but described constrained feeding choices shaped by poverty, reliance on social grants, environmental challenges, and limited access to diverse foods. Environmental challenges such as drought and lack of piped water further limited food production. Limited nutrition knowledge and reliance on informal information sources contributed to suboptimal feeding practices. Conclusions: Undernutrition in this rural setting is shaped by a complex interaction of economic hardship, environmental constraints, and limited caregiver knowledge. Community-based nutrition education, strengthened primary healthcare counselling, and multisectoral interventions addressing poverty, water access, and food security are essential to improve child nutrition outcomes. Full article

While global nutrient insufficiency remains a critical health challenge, eggs have emerged as a potential solution due to their profile as an accessible and nutrient-dense food source. To quantitatively assess this potential for mitigating nutrient insufficiencies and guide the production of nutrient-enriched eggs, the study proposes the concept of egg nutriomics, establishing a comprehensive evaluation system with 35 indicators across seven nutritional dimensions (fatty acids, amino acids, vitamins, trace elements, pigments, antioxidant capacity, and dietary restriction factors). Methodologically, the system normalizes raw analytical data into standardized scores (0–100) using indicator-specific functional models, with weights rationally allocated based on the essentiality of the nutrients. These quantitative metrics are subsequently translated into intuitive results using visualization tools such as heatmaps and radar charts. This study applied this system to evaluate six commercial egg varieties (pasteurized, lutein-enriched, ω-3 enriched, animal welfare, low-cholesterol, and conventional cage eggs), profiling multidimensional nutrition that allows for the intuitive visualization of performance scores across distinct dimensions. These profiles extend beyond comprehensive evaluation by revealing specific quantitative advantages—such as ω-3 enriched eggs scoring 79 in the fatty acid dimension compared to 49 for conventional eggs—thus providing a reference to guide precision modulation as illustrated by a dietary ω-3 enrichment case study involving 200 laying hens. Building upon this foundation, the strategy empowers a shift from the sole pursuit of high yields to precision nutritional modulation. This multi-dimensional strategy bridges nutritional analysis with production control, facilitating the development of nutrient-dense eggs as a potential application to mitigate human malnutrition. Full article

This study aimed to estimate dietary exposure to aflatoxins (AFs) and characterize its associated risks through the consumption of dried fruits and chocolates among the adult population of Yerevan, the capital city of Armenia. Asflatoxin B1 (AFB1) and total AFs were determined using HPLC in 10 composite samples of widely consumed dried fruits and chocolates, prepared by pooling 100 individual sub-samples into 5 dried fruits and 5 chocolate composites. Individual consumption data were obtained via food frequency questionnaires and were stratified by consumer groups and percentiles. Exposure scenarios (lower-, middle-, upper-bound and detected mean) were applied, and risk was assessed using the margin of exposure (MOE) approach with a BMDL₁₀ of 0.4 μg/kg bw/day. The study findings revealed that dried fruits had higher contamination levels (detected mean content of 10 μg/kg AFB1, 15 μg/kg total AFs) compared to chocolates (detected mean content of 0.5 μg/kg AFB1, and 0.9 μg/kg total AFs), resulting in lower MOE values despite smaller consumption quantities. Detectable AFs in dried fruits from open (street) markets exceeded the EU maximum limits, while Armenia currently lacks national regulatory limits for these products. MOEs were below 10,000 for most consumption groups, indicating a potential public health concern. This research emphasizes the urgent need for continuous monitoring and the establishment of harmonized national regulatory limits for AFs in dried fruits. Full article

Mycotoxin contamination remains a persistent threat to food safety in the Democratic Republic of the Congo (DRC) and neighboring countries, driven by conducive tropical agroecological conditions, inadequate post-harvest practices, and limited regulatory governance. This critical narrative review (2009–2024) synthesizes the occurrence data for major staple foods (maize, peanuts, cassava, sorghum, millet, and beans) and dairy products compiled from Google Scholar, ScienceDirect, MDPI and institutional sources. It examines the co-occurrence patterns, exposure pathways, and analytical and regulatory gaps. Warm, humid lowland environments favor Aspergillus and aflatoxins, whereas cooler, humid highland zones promote Fusarium, fumonisins, and deoxynivalenol. Across commodities, contamination intensifies along food value chains through inadequate drying, non-hermetic storage, insect damage, and prolonged handling, with processed products generally exhibiting the highest levels of mycotoxins. Regulated mycotoxins, including aflatoxins, fumonisins, trichothecenes, ochratoxins, and zearalenone, frequently exceed European Union (EU), East African Community (EAC), and Codex Alimentarius Commission (CAC) limits in staple foods. Their co-occurrence is widespread, including emerging mycotoxins such as beauvericin and enniatins, particularly in maize- and peanut-based products, raising concerns about potential additive or synergistic effects. Aflatoxin M1 in milk highlights plant–feed–animal–human transfer within a One Health framework. Despite increasing evidence, the available data remain fragmented and heterogeneous; rapid tests dominate, while few studies employ multi-mycotoxin LC-MS/MS methods. Cross-border trade between countries, such as Uganda, Tanzania, Zambia and Angola, facilitates the circulation of contaminated commodities in the absence of harmonized standards and risk-based controls. Priorities include harmonized regional surveillance, biomarker-based co-exposure assessment, cost-effectiveness evaluation of mitigation strategies, and regulatory alignment at borders. Coordinated, multisectoral action is essential to reduce chronic dietary exposure and improve food safety across the region. Full article

Gestational weight gain (GWG) and birth weight (BW) have a multifactorial etiology, which makes identifying the most influential determinants difficult. The association between variants of the FTO and LEPR genes has been explored as contributing factors to obesity in various age groups; however, their role in GWG and BW in adolescent mothers and their offspring is uncertain. To determine whether the presence of polymorphisms rs9939609 (FTO) and rs1137101 (LEPR) is associated with gestational weight gain and newborn weight in a cohort of adolescent mothers. Methods: A prospective cohort study of 305 mother-child dyads was conducted between 2020 and 2024. Genotyping of the single nucleotide variants (SNVs) rs9939609 of the FTO gene and rs1137101 of the LEPR gene was performed using real-time PCR and high-resolution melting analysis (qPCR-HRM), using maternal peripheral blood and umbilical cord blood samples. GWG, BW, energy intake, and other perinatal data were recorded and classified. Genetic data from 305 mother–offspring dyads were analyzed. The median maternal age was 16 years, and 71.4% had a normal pre-pregnancy body mass index (BMI). The most frequent genotypes were TT for FTO rs9939609 and AG for LEPR rs1137101. In both groups, the genotypic distribution significantly deviated from Hardy–Weinberg equilibrium (p < 0.0001). The AA genotype of FTO was associated with a higher probability of excessive gestational weight gain (GWG) after adjustment for pre-pregnancy BMI and dietary and sociodemographic factors. High protein and lipid intake increased the risk of excessive GWG, whereas adequate intake of carbohydrates and legumes showed a protective effect. An initial significant association was identified between the LEPR rs1137101 variant (AA allele) and low birth weight (LBW); however, this association was lost after adjustment for confounding factors. The FTO rs9939609 variant was significantly associated with GWG. On the other hand, the LEPR rs1137101 variant in the offspring showed an association with BW categorized by percentiles (in crude analysis), while the FTO variant showed no relationship with birth weight. Full article

Background: Vitamin D deficiency remains a widespread public health issue in Europe, despite the availability of sunlight, dietary sources, supplements, and food fortification. National fortification strategies differ substantially in their regulatory approaches, food vehicles, and fortification levels, influencing the population’s vitamin D intake and status. Objective: The primary objective of this study was to map vitamin D food fortification policies across European Union (EU) Member States, European Free Trade Association (EFTA) countries, and the United Kingdom (UK), focusing on regulatory frameworks, eligible food categories, and implementation models. Methods: A structured review of national legislation and official guidance on vitamin D food fortification was conducted between December 2025 and March 2026 across EU Member States (n = 27), EFTA countries (n = 4), and the UK. For EU Member States, the framework established by Regulation (EC) No 1925/2006 was examined alongside national implementation measures. For EFTA countries and the UK, corresponding national legislation and official regulatory guidance were reviewed. Data were extracted on fortification policy status, eligible food categories, legal basis, and fortification levels. Targeted searches of PubMed and Scopus were performed to identify modeling studies and policy analyses supporting the interpretation of the findings. Results: Fortification policies show marked heterogeneity. Mandatory fortification is limited to a few countries and specific foods: Finland (homogenized skim milk), Sweden (low-fat milk, fermented dairy, plant-based alternatives, and fat spreads), Belgium (margarine and selected fats), and Poland (margarine and fat spreads). In most other European countries, vitamin D fortification is voluntary under EU legislation or equivalent national legislation, depending on market uptake. Food vehicles vary regionally, with Northern Europe extending fortification beyond fats to include fluid milk and plant-based drinks, whereas other regions mainly fortify margarines, cereals, dairy products, and plant-based beverages. Fortification levels also differ, with some countries specifying maximal or exact levels, while others lack national standards. Data on fortified foods are limited in several Central and Southern European countries. Modeling indicates that multi-vehicle fortification is more effective than single-vehicle approaches, safely increasing population intakes while reducing deficiency prevalence. Conclusions: Vitamin D fortification policies across Europe are highly heterogeneous. Most countries rely on voluntary approaches, which provide limited coverage. Strengthening policy through mandatory and well-coordinated multi-vehicle strategies, informed by modeling and population-based studies, can improve vitamin D intake, reduce deficiency prevalence, and enhance health equity. Full article

This study aimed to systematically evaluate the effects of low-protein (LP) diets and their associated nutritional interventions on growth performance and intestinal health in weaned piglets through a meta-analysis. Following the PRISMA guidelines, 21 studies were selected from an initial set of 1720 to construct a database. A random-effects model was employed to assess the growth performance and intestinal health of weaned piglets, comparing LP diet with control diet, and LP diet + additive with LP diet alone. Heterogeneity was assessed using the I² statistic, and its sources along with publication bias were explored through meta-regression, subgroup analysis, and Egger’s linear regression. The results show that LP diets (crude protein < 18%) reduced final body weight (p < 0.001), average daily gain (p < 0.001), and gain-to-feed ratio (p < 0.001) of weaned piglets. Additionally, forest plot data show that LP diet (crude protein < 18%) decreased villus height and crypt depth in the jejunum and ileum of weaned piglets (p < 0.05). To mitigate these adverse effects, plant extracts, amino acids (AAs), fatty acids, vitamins, enzymes, and carbohydrates are commonly used as additives. Among these, the results show that LP diets supplemented with AAs and plant extracts increased average daily feed intake (p < 0.001) and ileal crypt depth (p < 0.05). Network meta-analysis further identified AAs and plant extracts as the most effective additives for improving growth performance of weaned piglets. In conclusion, dietary protein levels below 18% negatively affect the growth performance of weaned piglets, and supplementation with AAs or plant extracts represents a promising strategy to counteract these adverse effects. Full article

Background/Objectives: Emerging evidence suggests that ultra-processed food (UPF) consumption may be associated with depressive symptoms, yet data in the early postpartum period remain limited. This pilot study aimed to examine the association between UPF intake and postpartum depressive symptoms among women in the early postpartum. Methods: In this cross-sectional pilot study, 137 women within 6–8 weeks postpartum were recruited from hospitals, maternity clinics, and online support networks in Greece. Dietary intake was assessed using a validated food frequency questionnaire and classified according to the NOVA system. UPF consumption was categorized into quartiles. Postpartum depressive symptoms were evaluated using the Edinburgh Postnatal Depression Scale (EPDS), with clinically significant symptoms defined as EPDS ≥ 13. Multivariable logistic regression analyses were conducted, adjusting for sociodemographic and lifestyle factors. Results: The prevalence of clinically significant postpartum depressive symptoms was 29.9%. No statistically significant associations were observed in adjusted models. However, a higher prevalence of depressive symptoms was observed among women in the highest UPF intake quartile (40.0%) compared with lower quartiles (25.7–28.1%). Poor sleep quality was independently associated with higher odds of depressive symptoms, whereas breastfeeding was associated with lower odds. Confidence intervals were wide, indicating limited statistical precision due to the small sample size. Conclusions: While no statistically significant association was observed in multivariable analyses, a higher prevalence of depressive symptoms was noted among women in the highest UPF intake quartile. The wide confidence intervals indicate substantial uncertainty, and the findings should be interpreted with caution. Larger, adequately powered studies are required to confirm these findings. Full article

As rural residents face the dual challenges of transforming dietary structures and addressing nutritional health burdens, establishing a resilient food consumption system for rural households has become an urgent priority. Drawing on micro-level data from the China Land Economic Survey (CLES) for the period 2020–2022, this study employs two-way fixed effects models, an instrumental variable (IV) approach, and seemingly unrelated regression (SUR) techniques to examine the impact of agricultural production diversity on household food expenditure and dietary diversity, as well as the underlying mechanisms. The results reveal that agricultural production diversity yields a significant and robust dual-dividend effect within household food consumption systems: it not only reduces per capital food expenditure but also enhances dietary diversity. Mechanism analysis indicates that diversified production increases food self-sufficiency, thereby reducing cash outflows for essential food items, while simultaneously improving dietary diversity through increased agricultural income and greater agricultural commercialization. Heterogeneity analysis further shows that these effects are more pronounced in villages lacking rural industrial support and among non-ageing households. These findings suggest that, in contexts where market mechanisms remain underdeveloped, the uncritical pursuit of absolute agricultural specialization may not align with the livelihood and nutritional needs of rural residents. From the perspective of fostering a healthy and resilient food system, China should adopt differentiated agricultural support policies, encourage rural households to maintain an appropriate degree of production diversity, and strengthen local agricultural market infrastructure. Full article

Background: Given the limited evidence in the field, the present study aimed to explore the association of UPF intake with food literacy levels in an adult Mediterranean-based population. Methods: Self-reported demographic and anthropometric data were collected from 317 apparently healthy adults (52.5% males) Food literacy and dietary intake of this population were also assessed. Foods were classified as ultra-processed according to the NOVA system, and their contribution to total daily energy intake (%) was calculated. Then, participants were grouped into the (1) higher UPF intake (HUPFI), and (2) lower UPF intake (LUPFI) groups, based on the median value of this population as a cut-off. Results: Between-group analysis revealed that LUPFI scored statistically significantly higher than the HUPFI group in total food literacy (93.5 [84.0–104.0] vs. 86.0 [78.0–99.0], p < 0.001) and in three out of five food literacy sub-dimensions. Sub-analysis revealed no differences between LUPFI and HUPFI groups of individuals with normal weight. In participants with overweight or obesity, the LUPFI group scored lower than the HUPFI in the total food literacy score (95.0 [87.0–104.0] vs. 81.0 [70.0–94.0], p < 0.001) and in each sub-dimension. Conclusions: Higher UPF intake was associated, in adults with overweight or obesity, with lower levels of food literacy. Full article

Background/Objectives: Metabolic diseases are increasingly associated with diets low in bioactive compounds. Native maize varieties possess functional potential; however, they remain underutilized. Moringa oleifera leaf flour (MF), rich in protein and polyphenols, represents a promising functional ingredient. This study evaluated the incorporation of MF into red native corn tortillas and its effects on nutritional composition and antioxidant capacity, as well as assessed its hypoglycemic and hypolipidemic effects in Wistar rats. Methods: Tortillas were formulated with 5% MF. Nutritional composition was determined using standard AOAC methods, while bioactive compounds (total phenolics and flavonoids) and antioxidant activity were evaluated using Folin–Ciocalteu, aluminum chloride (AlCl₃) colorimetric, DPPH^•, and ABTS^•+ assays, respectively. Male Wistar rats (12 weeks old, with an approximate weight ofs 360 g; n = 5/group) were fed the experimental diets for 21 days with either a standard diet, a high-fat diet, or high-fat diets supplemented with MF or MF-enriched tortillas. Serum glucose, triglycerides, total cholesterol, and HDL were measured using enzymatic colorimetric methods. Data were analyzed by ANOVA followed by Tukey’s test (p < 0.05). Results: MF incorporation increased protein (+19.85%), dietary fiber (+18.51%), and mineral content (+41.03%) compared to control tortillas. Total phenolics and flavonoids increased by 114.0% and 184.7%, respectively. Antioxidant activity improved significantly, as evidenced by reductions in IC₅₀ values of 41.1% (DPPH^•) and 43.1% (ABTS^•). In vivo, MF-enriched tortillas reduced triglycerides by 68.4%, total cholesterol by 16.2%, and hepatic lipid accumulation by 31.8% compared to the high-fat diet group. Glucose levels showed a reduction of 8.5%, although not statistically significant (p > 0.05). Conclusions: The incorporation of MF into red corn tortillas significantly enhances their nutritional and functional properties. In vivo results also showed improvements in lipid profile and a non-significant reduction in glucose levels. These findings support the development of functional foods based on traditional staples with potential health benefits. Full article

Global poultry production continues to expand rapidly to meet the growing demand for affordable and high-quality animal protein. However, this growth raises pressing concerns about environmental sustainability, natural resource use, and public health. Although current initiatives, such as improved housing systems, optimized feeding practices, and partial soybean meal substitution, have helped mitigate some impacts, comprehensive integrated solutions remain underexplored. This review synthesizes emerging nutritional and management innovations that enhance the sustainability of poultry production while maintaining profitability. It addresses three central research questions: (1) Which alternative feed ingredients most effectively preserve animal performance while minimizing environmental burdens? (2) How can environmental management practices enhance resource efficiency and waste valorization? (3) What roles do life cycle assessment methodologies and policy frameworks play in advancing sustainable poultry systems? Evidence from 100 peer-reviewed studies, industrial data, and field analyses reveals that incorporating insect meals, algae, and agro-industrial by-products can reduce dependence on soybean meal by 20–40% and improve feed efficiency by 5–12% across various poultry production systems. Furthermore, integrating environmental management strategies, such as manure valorization, efficient water and energy use, and the adoption of renewable energy, substantially reduces greenhouse gas emissions and promotes circular economic principles. Life cycle assessment studies confirm that combined dietary and management interventions yield greater reductions in carbon footprint than isolated measures. Future research should focus on optimizing interactions among feed strategies, environmental management, and policy frameworks through digital technologies, nanomaterial-based feed additives, and region-specific sustainability plans to accelerate the transition toward resilient, climate-smart poultry production systems. Full article

Purpose: The aims of this study were to evaluate the feasibility of time-restricted eating (TRE) in patients with Cushing’s disease (CD) and assess its effects on body weight and metabolic parameters. Methods: Twelve CD patients in remission with obesity were enrolled in a TRE program restricting food intake to 10:00–18:00. Anthropometric data, glycemic and lipid profiles, and circadian cortisol secretion were assessed at baseline and post-intervention. Serum cortisol levels were measured at multiple time points to evaluate diurnal patterns. Results: Nine patients completed the study. Over the 12-week period, participants showed a significant reduction in body weight, with median values decreasing from 93.8 kg [83.1–106.5] to 82.6 kg [76.9–100.3] (p = 0.011). Body mass index (BMI) also declined from 37.6 kg/m² [34.2–39.7] to 34.4 kg/m² [32.6–38.3] (p = 0.012). No statistically significant changes were observed in fasting glucose, HbA1c, or lipid parameters. Notably, 24 h urinary free cortisol levels significantly decreased (p = 0.01), and serum cortisol showed a downward trend at all measured time points, with the most pronounced reductions during mid-day and evening hours. No clinical or biochemical evidence of CD relapse was observed during the 12-month follow-up. Conclusions: Time-restricted eating is a feasible and well-tolerated dietary approach for patients with CD in remission, promoting weight loss and modest improvements in metabolic markers and cortisol rhythmicity. Full article