Search Results (1,206)

Childhood obesity increases chronic disease risk, but no comprehensive synthesis has evaluated the impact of school-based combined nutrition education and physical activity interventions on cardiometabolic biomarkers in children aged 3 to 12 years. This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251085194). Five databases were systematically searched through June 2025. Twelve randomized controlled trials involving 18,231 children were included and assessed using the PEDro scale. Ten trials demonstrated significant improvements in at least one cardiometabolic biomarker. Blood pressure (8 studies) outcomes showed systolic reductions of 1.41–6.0 mmHg in six studies. Glucose metabolism (5 studies) improved in two studies with reductions of 0.20–0.22 mmol/L. Lipid profiles (7 studies) improved in three studies, including total cholesterol (−0.32 mmol/L). Insulin levels (5 studies) decreased significantly in two investigations. Anthropometric improvements included BMI and body fat. Physical activity increased by >45 min/week and dietary habits improved significantly. Programs with daily implementation (90-min sessions 4x/week), longer duration (≥12 months), family involvement (parent education), and curriculum integration (classroom lessons) showed superior effectiveness. Interventions targeting children with overweight/obesity demonstrated higher changes compared to the general population. However, methodological limitations included a lack of assessor blinding, absence of subject/therapist blinding, and inadequate retention rates. School-based interventions combining nutrition and physical activity can produce significant improvements in cardiometabolic biomarkers, supporting comprehensive, sustained multicomponent programs for early chronic disease prevention. Full article

Background: Type 2 diabetes (T2D) is a growing public health concern, particularly in low- and middle-income countries. Although prediabetes is a major risk factor for T2D, it remains largely underdiagnosed and untreated. Structured lifestyle interventions have proven effective in preventing diabetes, but their feasibility within the Brazilian public health system remains unclear. Methods: This multicenter pilot randomized controlled trial assessed the feasibility of a culturally adapted lifestyle intervention (PROVEN-DIA) across the five regions of Brazil. A total of 220 adults at high risk for T2D were randomized to an intervention group or a control group (usual care) and followed for three months. Both groups received similar educational content on healthy eating and physical activity, but the intervention group participated in a structured and personalized lifestyle program with regular follow-up sessions. The primary outcome was adherence to dietary recommendations, assessed using the BALANCE Index—a validated dietary score (range: 0–40) based on the Brazilian Cardioprotective Diet that classifies foods into color-coded groups according to nutritional quality—along with engagement in moderate-to-vigorous physical activity (MVPA). Secondary outcomes included diet quality (DQIR), anthropometric and metabolic parameters. Results: Feasibility was demonstrated by a 93.2% retention rate (n = 205). There was no significant difference in the primary outcome (simultaneous improvement in diet and MVPA). However, the PROVEN-DIA group exhibited significantly greater improvements in diet quality, with a 2.8-point increase in the BALANCE Index (vs. 0.5 in the control, p = 0.03), and a significant improvement in the DQIR (p < 0.001). No significant differences between groups were observed in MVPA, HbA1C, glycaemia, or body weight. Conclusions: The PROVEN-DIA intervention proved feasible within the Brazilian public health context, resulting in significant improvements in dietary quality among individuals at high risk for T2D. A larger trial with longer follow-up is warranted to evaluate its effectiveness in preventing the progression to diabetes. However, to enhance physical activity outcomes, specific adaptations and targeted strategies may be required to better support participant engagement in exercise. Full article

Legumes are vital sources of protein, dietary fibre and nutrients, making them crucial for global food security and sustainable agriculture. However, their widespread acceptance and consumption are often limited by undesirable sensory characteristics, such as “a beany flavour”, bitterness or variable textures. Addressing these challenges requires a comprehensive understanding of the complex molecular mechanisms governing appearance, aroma, taste, flavour, texture and palatability in legumes, aiming to enhance their sensory appeal. This review highlights the transformative power of multi-omics approaches in dissecting these intricate biological pathways and facilitating the targeted enhancement of legume sensory qualities. By integrating data from genomics, transcriptomics, proteomics and metabolomics, the genetic and biochemical networks that directly dictate sensory perception can be comprehensively unveiled. The insights gained from these integrated multi-omics studies are proving instrumental in developing strategies for sensory enhancement. They enable the identification of key biomarkers for desirable traits, facilitating more efficient marker-assisted selection (MAS) and genomic selection (GS) in breeding programs. Furthermore, a molecular understanding of sensory pathways opens avenues for precise gene editing (e.g., using CRISPR-Cas9) to modify specific genes, reduce off-flavour compounds or optimise texture. Beyond genetic improvements, multi-omics data also inform the optimisation of post-harvest handling and processing methods (e.g., germination and fermentation) to enhance desirable sensory profiles and mitigate undesirable ones. This holistic approach, spanning from the genetic blueprint to the final sensory experience, will accelerate the development of new legume cultivars and products with enhanced palatability, thereby fostering increased consumption and ultimately contributing to healthier diets and more resilient food systems worldwide. Full article

Vitamin A deficiency (VAD) remains a significant cause of preventable blindness worldwide, with ocular surface changes representing early manifestations that require prompt recognition and treatment. Conventional examination methods are capable of detecting advanced changes; however, subtle conjunctival abnormalities may be overlooked, potentially delaying the administration of appropriate interventions. We herein present the case of a 5-year-old Japanese boy with severe VAD due to selective eating patterns. This case demonstrates the utility of infrared photography as a novel diagnostic approach for detecting and monitoring conjunctival surface abnormalities. The patient exhibited symptoms including corneal ulcers, night blindness, and reduced visual acuity. Furthermore, blood tests revealed undetectable levels of vitamin A (5 IU/dL), despite relatively normal physical growth parameters. Conventional slit-lamp examination revealed characteristic sandpaper-like conjunctival changes. However, infrared photography (700–900 nm wavelength) revealed distinct abnormal patterns of conjunctival surface folds and keratinization that were not fully appreciated on a routine examination. Following high-dose vitamin A supplementation (4000 IU/day), complete resolution of ocular abnormalities was achieved within 2 months, with infrared imaging objectively documenting treatment response and normalization of conjunctival surface patterns. This case underscores the potential for severe VAD in developed countries, particularly in the context of dietary restrictions, thereby underscoring the significance of a comprehensive dietary history and a meticulous ocular examination. Infrared photography provides a number of advantages, including the capacity for non-invasive assessment, enhanced visualization of subtle changes, objective monitoring of treatment response, and cost-effectiveness due to the use of readily available equipment. This technique represents an underutilized diagnostic modality with particular promise for screening programs and clinical monitoring of VAD-related ocular manifestations, potentially preventing irreversible visual loss through early detection and intervention. Full article

Background: In a global panorama marked by a progressive rise in obesity, metabolic syndrome, and chronic non-communicable disease prevalence, nutrition education (NE) might play a pivotal role in restoring adoption and strengthening adherence to dietary patterns that protect human health. Therefore, the primary purpose of this work is to review the existing scientific literature studying NE programs aimed at schoolchildren in the decade 2014–2024 and evaluate the effectiveness of intervention tools. Methods: During the first phase of this research, a qualitative analysis was conducted to track similarity in intervention tools and strategies used in nutrition education programs. In the second phase, a quantitative analysis was carried out, extracting common parameters among studies and assessing their potential influence in improving adherence to the Mediterranean diet (MD). Results: A high degree of heterogeneity was observed in educational program designs and intervention tools, which were usually not properly described and justified. All studies that measured adherence to the MD registered an improvement after the intervention, in some cases even higher than 10%. However, this study found no relationship between common parameters (i.e., number of formal tools, number of non-formal tools, lesson duration, and program length) used in NE and the improvement in students’ adherence to MD. Conclusions: This research has contributed to outlining a general framework of NE and to promoting a systematic approach in this research field. Full article

Food safety concerns related to pesticide residues in fruits and vegetables have increased globally, particularly in regions where monitoring programs are scarce or inconsistent. This study provides the first multi-year evaluation of pesticide contamination and associated dietary risks in Cape Verde, an African island nation increasingly reliant on imported produce. A total of 570 samples of fruits and vegetables—both locally produced and imported—were collected from major markets across the country between 2017 and 2020 and analyzed using validated multiresidue methods based on gas chromatography coupled to Ion Trap mass spectrometry (GC-IT-MS/MS), and both gas and liquid chromatography coupled to triple quadrupole tandem mass spectrometry (GC-QqQ-MS/MS and LC-QqQ-MS/MS). Residues were detected in 63.9% of fruits and 13.2% of vegetables, with imported fruits showing the highest contamination levels and diversity of compounds. Although only one sample exceeded the maximum residue limits (MRLs) set by the European Union, 80 different active substances were quantified—many of them not authorized under the current EU pesticide residue legislation. Dietary exposure was estimated using median residue levels and real consumption data from the national nutrition survey (ENCAVE 2019), enabling a refined risk assessment based on actual consumption patterns. The cumulative hazard index for the adult population was 0.416, below the toxicological threshold of concern. However, when adjusted for children aged 6–11 years—taking into account body weight and relative consumption—the cumulative index approached 1.0, suggesting a potential health risk for this vulnerable group. A limited number of compounds, including omethoate, oxamyl, imazalil, and dithiocarbamates, accounted for most of the risk. Many are banned or heavily restricted in the EU, highlighting regulatory asymmetries in global food trade. These findings underscore the urgent need for strengthened residue monitoring in Cape Verde, particularly for imported products, and support the adoption of risk-based food safety policies that consider population-specific vulnerabilities and mixture effects. The methodological framework used here can serve as a model for other low-resource countries seeking to integrate analytical data with dietary exposure in a One Health context. Full article

Background/Objectives: The field of dietary supplements is changing and evolving quickly. Registered Dietitian Nutritionists are recognized as experts in nutrition and familiarity with the usage of dietary supplements is expected. However, education on the use of dietary supplements is not equal across accredited dietetic education programs, which can lead to disparities in dietitians’ feelings of preparedness, attitudes, and consequently experience of comfort regarding dietary supplements. The purpose of this study was to create the D-SCOPE Questionnaire (Dietitians’ Survey of Comfort, Opinions, and Preparedness in Education in Supplements) and validate it. This questionnaire assesses Registered Dietitian Nutritionists’ feelings of preparedness, comfort with use, and general attitudes in the field of dietary supplements. Methods: Face and content validity was established with dietitian, nutritionist, and statistician input. For recruitment, 2000 national randomly selected emails were obtained from the Commission on Dietetic Registration. Registered Dietitian Nutritionists (n = 248) responded to the survey email request. Descriptive statistics (reported as means ± standard deviation), principal axis factoring (exploratory factor analysis) with a direct oblimin rotation and Cronbach’s a reliability analysis were used for validation techniques. Results: Five factors were created, which explained about 63% of the variance in the questionnaire. The questionnaire was generally reliable, but the factor structure could change with a non-US population. Conclusions: As a unit, the D-SCOPE Questionnaire shows validity and reliability in assessing Registered Dietitian Nutritionists’ perceptions of preparedness and attitudes in the area related to dietary supplements. Full article

Background: Accelerated demographic aging in Hungary and across Europe presents significant public health and socioeconomic challenges, particularly in preserving cognitive function and preventing neurodegenerative diseases. Modifiable lifestyle factors—especially dietary habits—play a critical role in brain aging and cognitive decline. Objective: This narrative review explores the mechanisms by which Western dietary patterns contribute to cognitive impairment and neurovascular aging, with specific attention to their relevance in the Hungarian context. It also outlines the rationale and design of the Semmelweis Study and its workplace-based health promotion program targeting lifestyle-related risk factors. Methods: A review of peer-reviewed literature was conducted focusing on Western diet, cognitive decline, cerebrovascular health, and dietary interventions. Emphasis was placed on mechanistic pathways involving systemic inflammation, oxidative stress, endothelial dysfunction, and decreased neurotrophic support. Key findings: Western dietary patterns—characterized by high intakes of saturated fats, refined sugars, ultra-processed foods, and linoleic acid—are associated with elevated levels of 4-hydroxynonenal (4-HNE), a lipid peroxidation product linked to neuronal injury and accelerated cognitive aging. In contrast, adherence to Mediterranean dietary patterns—particularly those rich in polyphenols from extra virgin olive oil and moderate red wine consumption—supports neurovascular integrity and promotes brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) activity. The concept of “cognitive frailty” is introduced as a modifiable, intermediate state between healthy aging and dementia. Application: The Semmelweis Study is a prospective cohort study involving employees of Semmelweis University aged ≥25 years, collecting longitudinal data on dietary, psychosocial, and metabolic determinants of aging. The Semmelweis–EUniWell Workplace Health Promotion Model translates these findings into practical interventions targeting diet, physical activity, and cardiovascular risk factors in the workplace setting. Conclusions: Improving our understanding of the diet–brain health relationship through population-specific longitudinal research is crucial for developing culturally tailored preventive strategies. The Semmelweis Study offers a scalable, evidence-based model for reducing cognitive decline and supporting healthy aging across diverse populations. Full article

A total of 38% of Americans do not meet the Recommended Dietary Allowance (RDA) for calcium including those at risk for osteoporosis. To increase the percentage of patients at risk for osteoporosis who achieve goal calcium RDA intake, a collaborative specialty pharmacy-registered dietitian-nutritionist (RDN) quality improvement program was developed. Patients aged 18 to 90 years old receiving osteoporosis therapy (denosumab, teriparatide, zoledronic acid) or medications that increase bone loss (elagolix, oral prednisone) were provided with a structured assessment and educational intervention. Daily calcium intake included patient self-reported dietary intake plus supplement use. Written and verbal education on increasing dietary intake based on patient preferences was provided with 5 calcium-rich food-source store coupons. Recommendations for supplement selection (citrate vs. carbonate) and/or medication-related problem resolution were provided. Follow-up occurred at 3–6 months. Fifty patients enrolled [94% female, mean age 66.6 years (SD 15.3)] were taking denosumab (36), teriparatide (1), zoledronic acid (1), elagolix (7) and prednisone (5). The mean baseline daily dietary calcium intake was 500 mg (SD 247) with none achieving goal intake with diet alone. Average calcium supplement use in 22 (44%) patients was 686 mg daily (SD 284). At baseline, 17 (34%) met goal daily calcium intake compared to 30 (60%) at post intervention follow-up (p = 0.009). Over half of the store coupons were redeemed. A specialty pharmacy-RDN customized intervention program provides a model for aiding patients to modify calcium intake. Full article

Despite recent advances in the treatment of obesity, lifestyle medicine remains foundational to the treatment of individuals with obesity, regardless of the modality chosen by the patient with the guidance of the clinician they are working with, including in conjunction with, as appropriate, anti-obesity medications and metabolic surgery. Lifestyle medicine involves the use of diet, exercise, sleep, stress, and other lifestyle modalities in the treatment of disease. Clinicians and health systems should, after a patient-centered discussion with the patient, do their best to ensure access to lifestyle treatments. Gold standard guidelines recommend intensive, multicomponent lifestyle change programs for obesity treatments with evidence-based diet and exercise counseling and established, theoretically driven behavior change components. Clinicians treating obesity should be aware of their own biases, make efforts to reduce stigmatizing experiences in their practice, and address weight stigma in their treatment plans as needed. A variety of dietary patterns can be used to support patients with obesity, and clinicians should make evidence-based but patient-centered recommendations that aim to maximize adherence. Diet and exercise can play an important role in reducing the side effects of treatment and optimizing outcomes in weight loss, attenuating the effects of metabolic adaptation, and weight maintenance. Exercise should be increased gradually to reduce injury with a goal of 200–300 min (approximately 3.3–5 h) of moderate to vigorous intensity exercise per week to maximize weight maintenance effects with exercise prescriptions customized to patients risks. A variety of practice models can be leveraged along with the use of an interdisciplinary team to provide lifestyle medicine care for those with obesity. Full article

Geometric morphometrics is performed on different species in different contexts. Here, the aim was to investigate morphological differences in the head of the Sanmartinero Creole bovine to examine head shape variations between sexes using geometric morphometric methods. A sample of cranial pictures of 43 animals (13 males and 30 females) was obtained, and form (size + shape) was studied by means of geometric morphometric techniques using a set of 14 landmarks. This approach eliminated potential dietary effects, ensuring that the observed shape variations were primarily due to intrinsic morphological differences. Sexual dimorphism was found in form (for both size and shape) of the head of the Sanmartinero Creole bovine breed. Males had significantly larger heads based on centroid size (U = 714, p = 0.0004), confirming true sexual size differences, and Principal Component Analysis revealed overlapping head shapes with sexual dimorphism concentrated at midline sagittal landmarks (between the most rostral and caudal orbit points) and paired lateral points, indicating that males have broader and longer heads. The two evaluated characters (head size and shape) are of special interest for the conservation of the breed, especially in those cases whose objectives are to maintain the uniqueness, distinctiveness, and uniformity of the populations. This study analyzed animals subjected to the same feeding program, ensuring the elimination of additional variables. Full article

Background: The gut microbiota is increasingly recognized as a key modulator in obesity management, influencing host energy balance, lipid metabolism, and inflammatory pathways. With obesity prevalence continuing to rise globally, dietary interventions that promote beneficial microbial shifts are essential for enhancing weight loss outcomes and long-term health. Objective: This study investigated the effects of the multicomponent Weight Loss Maintenance 3 Phases Program (WLM3P), which integrates caloric restriction, a high-protein low-carbohydrate diet, time-restricted eating (10h TRE), dietary supplementation (prebiotics and phytochemicals), and digital app-based support on gut microbiota composition compared to a standard low-carbohydrate diet (LCD) in adults with obesity. The analysis focused exclusively on the 6-month weight loss period corresponding to Phases 1 and 2 of the WLM3P intervention. Methods: In this sub-analysis of a randomized controlled trial (ClinicalTrials.gov Identifier: NCT04192357), 58 adults with obesity (BMI 30.0–39.9 kg/m²) were randomized to the WLM3P (n = 29) or LCD (n = 29) groups. Stool samples were collected at baseline and 6 months for 16S rRNA sequencing. Alpha and beta diversity were assessed, and genus-level differential abundance was determined using EdgeR and LEfSe. Associations between microbial taxa and clinical outcomes were evaluated using regression models. Results: After 6-month, the WLM3P group showed a significant increase in alpha diversity (p = 0.03) and a significant change in beta diversity (p < 0.01), while no significant changes were observed in the LCD group. Differential abundance analysis revealed specific microbial signatures in WLM3P participants, including increased levels of Faecalibacterium. Notably, higher Faecalibacterium abundance was associated with greater reductions in fat mass (kg, %) and visceral adiposity (cm²) in the WLM3P group compared to LCD (p < 0.01). Conclusions: These findings suggest a potential microbiota-mediated mechanism in weight loss, where Faecalibacterium may enhance fat reduction effectiveness in the context of the WLM3P intervention. Full article

Body composition is associated with multiple factors. The main objective of this study is to determine the association between diet and sociodemographic factors on the body structure and composition of university students at a public university in Ecuador. This cross-sectional study allowed for the collection of detailed body composition and dietary data from 204 students (41.7% men and 58.3% women, with an average age of 23.3 ± 4.4 years). The study was conducted using validated questionnaires and bioimpedance techniques. Statistical analysis included ANOVA tests, complemented by a PCA-Biplot, to examine the relationships between study variables. Statistical analysis revealed that men’s birthplace had a significant impact on several body measurements, such as hip circumference and weight, but no significant differences were observed in body structure and composition based on nutrient intake. Furthermore, larger upper-arm circumference in women was correlated with higher fat intake. The results of the multivariate analysis indicated a differential influence of dietary components on body composition. The study highlights the need for nutritional intervention strategies and educational programs that consider the diversity of students’ backgrounds to promote healthy habits and mitigate the negative effects of eating habits and irregular physical activity patterns on their health and body composition. Full article

Background/Objectives: The complex relationship between nutrition and mental well-being has been widely documented, with empirical evidence supporting both the influence of dietary habits on psychological health and, conversely, the impact of mental state on food choices. However, a critical gap remains in understanding the mechanisms underlying this interaction. While previous literature have examined various biological and psychological mediators, limited attention has been given to the potential mediation role of interpersonal relationships in shaping this dynamic. This article seeks to address this theoretical gap by exploring how the quality of social interactions—both in their intentional dimension and in their lived experiential aspect—may function as a key mediator between nutrition and mental well-being. Methods: Methodologically, a combination of systematic review (PRISMA) and narrative review was employed, given that the findings of the systematic review alone are insufficient to formulate a hypothesis that requires interdisciplinary dialog in a still emerging and underexplored field. Results: The hypothesis we aim to propose is whether the quality of interpersonal relationships acts as a catalyst and enhancer of the effect of nutrients on mental health. Conclusions: This could open new avenues for the design of dietary interventions and mental well-being programs from a socially integrated approach. Full article

Background/Objectives: Psychological distress is common among university students and often co-occurs with unhealthy lifestyle patterns. However, most studies examine physical activity (PA) and dietary intake (DI) in isolation, overlooking how these behaviors interact under stress. This study aimed to identify and compare integrated PA and DI behavior patterns among students with low vs. high psychological distress. Methods: A cross-sectional case–control design was used with 209 students (aged 19–21). Questionnaires included the International Physical Activity Questionnaire (IPAQ), Questionnaire of Eating Behavior (QEB), and Depression Anxiety Stress Scales-21 items (DASS-21). Behavioral patterns were assessed using a cophylogenetic approach (tanglegrams, cophenetic statistics), and predictive behaviors were analyzed using stepwise logistic regression. Results: Permutational Multivariate Analysis of Variance (PERMANOVA) revealed significant group differences in PA–DI structure (F = 3.91, R² = 0.0185, p = 0.001). Tanglegram and PACo analyses showed tighter PA–DI alignment in high-distress individuals, suggesting more rigid, compensatory behavior profiles. Logistic regression identified vigorous PA (OR = 1.80, 95% CI: 1.33–2.50, p < 0.001) and fast food intake (OR = 1.43, 95% CI: 1.05–1.98, p = 0.026) as significant distress indicators. Sweets intake showed a non-significant trend (OR = 1.33, p = 0.064). Conclusions: Students with higher psychological distress exhibit complex lifestyle co-patterns combining risk (e.g., fast food) and compensatory behaviors (e.g., vigorous PA). Health promotion should address PA and DI jointly, and screening for distress should be integrated into student wellness programs. Full article