Search Results (2,674)

Purpose: Anemia remains a major public health concern among vulnerable rural adolescent girls in many countries, including India. This study aimed to assess the prevalence of anemia, nutritional status, and anemia-related knowledge, attitudes, and practices (KAP) among school-going rural adolescent girls, along with predictors of KAP score, complemented by stakeholder perspectives. Methods: A mixed-methods cross-sectional study was conducted among 553 school-going adolescent girls aged 14–19, selected through a multi-stage stratified random sampling technique from three rural districts of Andhra Pradesh, India. Quantitative data were collected using a structured questionnaire assessing KAP, anthropometric measurements to collect Body Mass Index (BMI) and middle upper arm circumference (MUAC), dietary assessments using a dietary diversity score, and hemoglobin estimation using standardized procedures. Qualitative insights were obtained through focus group discussions (FGDs) with teachers, parents, frontline health workers, and community leaders and analyzed thematically. Logistic regression analysis was performed to identify predictors of KAP. Results: The prevalence of anemia among the participants was 55.3%, and 30.7% were underweight. Although over half of the girls demonstrated adequate knowledge of anemia, only 39.6% reported good anemia-preventive practices, indicating a significant gap between knowledge and practice. Dietary scores indicated micronutrient-deficient diet consumption by participants (36.2%), which might be contributing to anemia. Multivariable analysis revealed that maternal education, hemoglobin status, diet patterns, and type of school attended were significantly associated with KAP scores. Qualitative findings highlighted challenges related to health-seeking behavior, cultural misconceptions, gaps in awareness and implementation of existing adolescent health programs. Conclusions: Anemia remains highly prevalent among rural school-going adolescent girls in Andhra Pradesh, with suboptimal anemia-preventive practices despite moderate levels of knowledge. Strengthening school-based nutritional education, improving dietary diversity, and enhancing the reach and effectiveness of adolescent health programs through community engagement may help combat anemia. Full article

Background/Objectives: Adolescents and university students appear to be at increased risk for internet addiction (IA), while disordered eating behavior (DEB) is common in these age groups. At the same time, adherence to the Mediterranean diet (MD) has declined in many countries. This study aimed to explore the potential association between IA, DEB and MD compliance among high school and university students. Methods: A total of 212 students aged 15–24 years participated in this cross-sectional study conducted in Greece. Data were collected via an online questionnaire including the Internet Addiction Test (IAT), KIDMED, and EAT-26 scales. Descriptive statistics, chi-square tests, and univariate and multivariate logistic regression analyses were performed. Results: Most participants demonstrated normal internet use (69.8%), while 23.1% showed mild IA and 7.1% moderate IA. Regarding dietary habits, 9.4% had low MD adherence, 52.8% moderate and 37.7% high adherence. A total of 15.6% scored above the EAT-26 cut-off, indicating risk for disordered eating behavior. IA was only significantly associated with urbanization (p = 0.014). MD adherence was not associated with gender, urbanization, financial or education status. Multivariate logistic regression showed that female gender (OR = 9.28, 95% CI: 2.10–40.91, p = 0.003) and moderate IA (OR = 6.70, 95% CI: 1.71–26.35, p = 0.006) were significant predictors of disordered eating, while educational status and MD adherence were not significant predictors. Conclusions: Moderate IA and female gender were strongly associated with an increased risk for disordered eating. Further qualitative and clinical studies are needed to better understand the interaction between IA, eating behaviors, and dietary patterns in young people. Full article

This review classifies plant-derived functional ingredients in pet food according to phytochemical groups and application forms, including direct oral supplementation and incorporation into complete diets. Polyphenols and plant extracts exert prominent antioxidant (singular), anti-inflammatory, immunomodulatory, and microbiome-regulating effects. Microalgae and omega-3 sources support lipid metabolism, cardiovascular function, and skin integrity. Cannabinoids demonstrate dose-dependent responses in dogs, while cats generally tolerate long-term administration and exhibit notable benefits in chronic pain management. Combinations of botanical extracts with complementary bioactives and fermented botanical preparations exhibit multi-target functionality, with dogs showing pronounced biochemical and microbiome modulation, whereas cats display more behavioral and functional improvements. Phytochemicals operate through integrated multi-level regulation, including activation of antioxidant enzymes, modulation of inflammatory cytokines and T-lymphocyte ratios, microbial metabolic shifts toward short-chain fatty acid production, and regulation of lipid metabolism. Dogs demonstrate marked effects on hepatic function, reproductive resilience, microbiome diversity, CD4+/CD8+ balance, and cholesterol control. In contrast, cats show greater benefits in inflammation reduction, pain relief, intestinal integrity, and long-term safety. These species-specific responses underscore the importance of precision formulation and highlight the emergence of plant-based “pharma-pet nutrition” integrating nutritional and biochemical strategies for targeted health promotion. Full article

Background: Adolescence is a critical developmental period during which dietary habits are formed and may influence long-term health outcomes. Monitoring changes in adolescents’ eating behaviors and nutrition-related knowledge over time is important for developing effective health promotion strategies. The aim of this study was to compare adolescents’ (Lower Silesia, Poland) dietary habits and nutritional knowledge between two study periods (2011 and 2023) using comparable survey methods. Methods: A repeated cross-sectional comparison of two independent cohorts was conducted using an identical questionnaire in both study periods. The 2023 cohort included 14-year-old primary school students (n = 100; 48 girls and 52 boys), while the comparison group consisted of adolescents aged 13–15 years assessed in 2011 (n = 377; 202 girls and 175 boys). Anthropometric measurements and self-reported data on dietary habits and nutritional knowledge were analyzed using descriptive statistics and group comparison tests. Results: The findings indicate changes in selected dietary behaviors and levels of nutritional knowledge among adolescents over the studied period. A higher percentage of students in 2023 reported eating four meals per day and obtaining information about healthy eating from the Internet rather than from television. Students in 2023 were also more likely to recognize the relationship between diet and attention, identify the harmful effects of energy drinks and excessive fast-food consumption, and provide correct answers regarding proper nutrition. Nutritional knowledge improved over time, with a mean percentage of correct responses of 71.9% in 2023 compared with 63.7% in 2011. Although nutritional awareness improved in several areas, certain unhealthy eating habits remained prevalent, including irregular breakfast consumption and frequent intake of sweets. Changes in the distribution of body weight categories were also observed, with gender-specific differences between cohorts. Conclusions: The results suggest that improvements in nutritional knowledge alone may not be sufficient to ensure positive changes in dietary behavior among adolescents. Continued monitoring of adolescent nutrition and the development of comprehensive health promotion strategies addressing both knowledge and environmental influences remain necessary. Full article

Background/Objectives: Thinness is widely idealized as a standard of beauty, and late school-age girls are increasingly exposed to sociocultural pressures that may be associated with excessive drive for thinness and maladaptive body esteem. These body-related cognitive distortions often emerge regardless of actual weight status and may precede unhealthy dieting behaviors and emotional difficulties. This study aimed to develop and evaluate a school-based Rational Emotive Behavior Therapy (REBT) intervention designed to modify excessive drive for thinness and maladaptive body esteem among late school-age girls. Methods: A quasi-experimental, non-equivalent control group design with repeated measures was employed. Participants were 62 girls in grades 5–6 recruited from two public elementary schools in South Korea (experimental group: n = 30; control group: n = 32). The experimental group participated in a five-week REBT intervention consisting of 10 structured sessions grounded in the A-B-C-D-E model, while the control group received no intervention. Outcomes were assessed at pretest, posttest, and follow-up, including drive for thinness, body esteem, positive affect, negative affect, disordered eating behaviors, and social media overuse. Data were analyzed using repeated measures ANOVA. Results: Significant group × time interaction effects were observed for drive for thinness, body esteem, positive affect, negative affect, and disordered eating behaviors, with greater changes observed in the experimental group. No significant group × time interaction was found for social media overuse. Conclusions: The school-based REBT intervention was associated with reductions in excessive drive for thinness and improvements in body esteem and was also associated with changes in emotional outcomes and reductions in disordered eating behaviors among late school-age girls. These findings support early cognitive modification as a preventive strategy within school settings. Full article

Background/Objectives: In recent years, the migrant population has been increasing. Migrants are at risk for malnutrition, mental disorders and related health problems. In this study, we aimed to examine the relationships among diet quality, eating behavior, posttraumatic stress disorders and sleep quality in Syrian migrants. Methods: This study included 78 female and 72 male Syrian adult migrants. The participants completed a questionnaire including demographic information, the Pittsburgh Sleep Quality Index, the Posttraumatic Stress Disorder Short Scale, and a three-factor eating questionnaire. For the diet quality calculation, a 24 h retrospective food consumption record was taken. Results: A total of 94.0% of the participants had mild to moderate risk of posttraumatic stress disorder. It was determined that 90.7% of Syrian migrants had low or moderate diet quality. There was a positive correlation between the PTSD score and age (r = 0.244) and the Pittsburgh sleep quality index score (r = 0.244) and between the Pittsburgh sleep quality index score and uncontrolled eating (r = 0.171) (p < 0.05). The probability of impaired sleep quality increased in individuals with PTSD scores in the T2 (11–19 points) (OR: 1.342; 95% CI: 1.073–1.678) and T3 (20–31 points) (OR: 1.485; 95% CI:1.157–1.905) groups, whereas the probability of improved diet quality increased in individuals in the T2 (11–19 points) (OR: 1.042; 95% CI: 1.000–1.086) group. Conclusions: Poor diet quality, risk of posttraumatic stress disorder and poor sleep quality are very common among Syrian migrants. In this respect, evaluating Syrian migrants and taking necessary precautions may help reduce the risk of chronic diseases related to nutrient deficiencies and mental problems. There is a need for policies and programs to manage PTSD among Syrian refugees. Full article

Background: The Mediterranean diet (MedDiet) has been associated with anti-inflammatory effects and potential benefits in several chronic conditions. However, adherence to the MedDiet and its relationship with lifestyle factors and disease severity across different rheumatological diseases remain poorly characterized. Objectives: This study aimed to evaluate differences in MedDiet adherence among patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and fibromyalgia (FM), and to explore its association with cardiovascular comorbidities, bowel habits, and disease-related outcomes. Methods: In this monocentric cross-sectional study, adherence to the MedDiet was assessed using the 14-item PREDIMED questionnaire. Self-reported data on sociodemographic characteristics, cardiovascular comorbidities, bowel habits, and dietary behaviors were collected through questionnaires. Disease activity and severity were assessed using validated disease-specific measures. Differences in MedDiet adherence across diagnostic groups were evaluated using non-parametric tests. Multivariable models were performed to examine associations between MedDiet adherence and cardiovascular comorbidities or disease outcomes, adjusting for potential confounders including age, sex, BMI, smoking status, and educational level. Results: A total of 422 participants were included (RA n = 165, PsA n = 85, FM n = 172). Significant differences in MedDiet adherence were observed across diagnostic groups (p < 0.001), with the highest adherence in RA, intermediate values in PsA, and the lowest in FM. Compared with the other groups, a higher proportion of FM participants reported food intolerances (46.5%) and restrictive diets, including lactose-free (34.9%) and gluten-free (15.1%) diets. In the FM group, high adherence to the MedDiet was significantly associated with lower FIQR scores (β = −16.9; 95% CI −32.1 to −1.7; p = 0.01) and lower PDS scores (β = −4.34; 95% CI −7.81 to −0.86; p = 0.01). Sensitivity analyses using the continuous PREDIMED score confirmed these associations. Conclusions: Adherence to the MedDiet differs across rheumatological diseases, with the lowest adherence observed in FM. Higher adherence was associated with lower disease severity and impact in FM. These findings highlight the potential relevance of nutritional counselling in rheumatological diseases and support the need for longitudinal and interventional studies evaluating the role of the MedDiet within multidisciplinary disease management. Full article

Background: Parental knowledge and perceptions towards Functional Foods (FFs) play a critical role in shaping children’s dietary behaviors. This study aimed to investigate dietary habits, FFs knowledge and perceptions among Greek primary school children and their parents and to evaluate the feasibility of a one-month pilot asynchronous nutrition education program. Methods: A cross-sectional study included 374 children aged 9–11 years and 159 parents from urban (Thessaloniki) and rural (Lemnos) areas. Children completed questionnaires on dietary habits, FFs knowledge and Mediterranean Diet (MD) adherence (KIDMED score), while parents provided sociodemographic information, BMI, dietary habits, FFs knowledge and perceptions. A pilot asynchronous nutrition education intervention was delivered via pre-recorded videos on FFs, the MD, portion sizes and food label interpretation, with participation tracked and program evaluation conducted among parents. Data was analyzed using IBM SPSS Statistics (version 28). Descriptive statistics were calculated, group differences were assessed with t-tests and ANOVA and associations between variables were examined using chi-square tests and Pearson correlations (p < 0.06). Results: Children showed moderate MD adherence, frequent fast-food and soft drinks consumption and low FF knowledge, with a substantial gap between perceived and actual understanding. Parental FF knowledge was uneven, higher among normal-weight participants and largely limited to fortified products. Positive associations were found between children’s and parents’ diet quality and natural FF consumption, as well as between parental and child physical activity. The asynchronous intervention was positively rated; substantial attrition was observed across sessions and follow-up, which limited the ability to assess the intervention’s effects on behavioral change. Conclusions: This study highlights critical gaps in FFs knowledge among families and demonstrates that asynchronous, family-based nutrition education is feasible but challenged by engagement attrition. Targeted interventions are needed to clarify FF concepts and promote healthier family dietary behaviors. Full article

Background: Encouraging fruit and vegetable (FV) consumption early in childhood is important for long-term healthy eating. Though parents play an important role in shaping children’s FV-related taste preferences and consumption, validated instruments assessing the range of parenting practices that specifically support young children’s FV intake are scarce. Furthermore, little attention has been given to low-income families, cultural inclusivity, and FV practices across different settings. The current study sought to conduct an initial examination and explore the measurement equivalency of a new FV parenting practices questionnaire (FVPPQ) across racially/ethnically diverse groups that address these gaps. Methods: Data for this paper came from a large project focused on parents’ FV parenting practices with young children enrolled in Head Start programs in the southern part of the U.S. Inclusion criteria were (a) parent/legal guardian being eighteen or older, (b) being the primary person responsible for child feeding, and (c) the child not requiring a special diet (e.g., diabetic). Using a multi-phases project approach, we (1) developed a preliminary conceptual map of parenting practice domains by reviewing existing measures on FV parenting practices; (2) completed and content-analyzed data from 18 focus groups (n = 62) to identify and further revise the preliminary conceptual map of domains, (3) administered a questionnaire with 11 domains of FV parenting practices, and then (4) empirically explored and reduced the measure while evaluating its content, construct, and criterion validity, and cultural equivalency across Non-Hispanic White, Hispanic White, and Black parents (n = 281). Results: Findings from Phases 1 and 2 generated a 107-item questionnaire that was reduced during phase 3 through a series of principal component and confirmatory factor analyses to the final FVPPQ with 21 items in four unique domains, showing good variability and inter-item consistency reliability: (1) Availability (5 items); (2) modeling (5 items); child-focused (5 items); and pressure (6 items). Three of the four domains evidenced cultural equivalency. Conclusions: The FVPPQ with four unique subscales demonstrated good content, construct validity, and partial measurement equivalency across racially/ethnically diverse groups of parents. Further confirmatory validation is warranted in larger samples, but the FVPPQ might be a promising and easily administered measure for research and applied interventions in nutrition, health behavior, and parenting contexts. Full article

Background: Healthy dietary behaviours are essential for maintaining health, functional independence, and quality of life in later life. Family members are a key source of social support for community-dwelling older adults, yet the ways in which family support shapes older adults’ dietary behaviours, particularly among those who retain autonomy, remain insufficiently synthesized. Therefore, this review aims to map how family support influences dietary behaviours among community-dwelling older adults by examining the forms, roles, and contextual influences of family support within a Social Support Theory framework. Methods: Following Joanna Briggs Institute guidance and PRISMA-ScR reporting standards, we conducted a scoping review of empirical studies published in English or Chinese. Searches were conducted across PubMed, CINAHL, PsycINFO, Web of Science, and Scopus from inception to 2025. Quantitative and qualitative evidence was synthesised using a convergent–segregated mixed-methods approach. Qualitative findings were deductively mapped to instrumental, informational, emotional, and esteem support domains. Results: Nineteen studies were included. Quantitative evidence indicated that family support, particularly shared meal preparation, joint dietary adherence, and autonomy-supportive encouragement, was generally associated with better diet quality, dietary adherence, and nutritional outcomes. Qualitative findings showed that the influence of family support depended on relationship dynamics and contextual factors, including communication patterns, autonomy negotiation, shared responsibility, and cultural expectations. Conclusions: Family support plays a multifaceted and context-dependent role in shaping dietary behaviours among community-dwelling older adults. These findings can inform the development of family-inclusive strategies and interventions that promote healthy dietary behaviours while respecting older adults’ autonomy and relational contexts. Full article

Background/Objectives: Although lifestyle patterns, including sleep and meal timing, have been associated with diet quality, previous studies have frequently relied on time-averaged data, which can obscure day-to-day intake variability. Using data from a food-logging mobile application, we aimed to elucidate the association between mealtime irregularity and nutrient intake variability. Furthermore, we explored whether the association between meal timing and diet quality differs depending on mealtime regularity. Methods: Chrononutritional characteristics were calculated for 742 female mobile application users who provided daily dietary records for approximately 1 month. Nutrient intake variability was evaluated using the coefficient of variation (CV). Diet quality was assessed based on the energy-adjusted ratio of nutrient intake to the reference values from the Dietary Reference Intakes for Japanese. Generalized additive models adjusted for age, body mass index, and physical activity were employed for analyzing associations. Results: Greater mealtime irregularity was associated with higher CVs in the daily intake of most nutrients investigated. Regarding diet quality, a marginal interaction was observed between mealtime regularity and dinner timing (p for interaction = 0.062). Specifically, the irregular mealtime group demonstrated a significant linear decline in diet quality with later dinner times (p for trend = 0.0112), whereas no significant decline was observed in the regular mealtime group (p for trend = 0.5219). Conclusions: Our findings suggest that mealtime regularity, alongside meal timing, is a significant factor involved in nutrient intake variability and diet quality, underscoring its significance as a health-related behavior in chrononutrition. Full article

Background: Adolescence represents a critical period for the adoption of lifestyle behaviors that may influence physical health, emotional well-being, and health-related behaviors later in life. However, limited evidence exists regarding the combined association of dietary habits and physical activity with motivation toward physical education, particularly among adolescent girls from different residential environments. Objective: This study aimed to examine the relationship between adherence to the Mediterranean diet, physical activity levels, and motivation toward physical education among adolescent girls from urban and rural settings. Methods: A cross-sectional study was carried out involving girls aged 12 to 14 years (n = 217; N_Urban = 108 and N_Rural = 109). Adherence to the Mediterranean diet, physical activity levels, and motivational dimensions toward PE were assessed using validated questionnaires. Differences between groups were analyzed using analysis of variance (ANOVA), and an analysis of covariance (ANCOVA) was performed controlling for physical activity levels. Effect sizes were calculated using partial eta squared (η²p). Results: Significant differences were observed in intrinsic motivation, identified regulation, introjected regulation, and amotivation according to adherence to the Mediterranean diet (p < 0.05), with small to moderate effect sizes (η²p = 0.029–0.040). Post hoc analyses indicated that girls with optimal adherence to the Mediterranean diet exhibited higher intrinsic motivation toward PE compared with those with low adherence. The ANCOVA revealed that higher physical activity levels were significantly associated with greater intrinsic motivation, particularly among girls from urban environments. No significant differences were found between urban and rural environments in overall physical activity levels or dietary adherence. Conclusions: Greater adherence to the Mediterranean diet and higher levels of physical activity are associated with more self-determined motivational profiles toward physical education in adolescent girls. These findings highlight the importance of integrated school-based interventions that promote healthy eating and active lifestyles to enhance motivation and engagement in PE among adolescent girls. Full article

Background/Objectives: Diet quality and physical activity are modifiable lifestyle factors linked to depressive symptoms, but their joint association—and potential variation by sex and age—remains unclear, particularly in Asian populations. This study examined the joint association of diet quality, measured by the Korean Healthy Eating Index (KHEI), and physical activity (PA) with depressive symptoms in Korean adults. Methods: We analyzed 17,737 adults aged ≥20 years from 2014, 2016, 2018, and 2020 KNHANES. Diet quality and PA were each dichotomized at the median to construct four lifestyle groups. Depressive symptoms were defined as Patient Health Questionnaire-9 (PHQ-9) ≥ 10. Survey-weighted multivariable logistic regression adjusted for sociodemographic factors, health-related behaviors, and major chronic diseases was performed, and stratified analyses were conducted by sex and age to explore potential variation across subgroups. Results: Overall, 4.6% of participants had depressive symptoms. Compared with the Low KHEI & Low PA group, the High KHEI & High PA group had substantially lower odds of depressive symptoms (aOR 0.55, 95% CI 0.42–0.73). In sex-stratified analyses, this joint association was significant only among women (aOR 0.48, 95% CI 0.35–0.66). In age-stratified analyses, significant associations were observed in adults aged 45–65 years (aOR 0.42, 95% CI 0.26–0.66) and ≥65 years (aOR 0.41, 95% CI 0.27–0.63). Conclusions: High diet quality combined with high physical activity was associated with markedly lower odds of depressive symptoms, particularly among women and middle-aged to older adults. These findings support integrated lifestyle strategies targeting both diet quality and physical activity, tailored to demographic and social contexts to enhance mental-health benefits across diverse populations. Full article

Background and Objectives: Emphysema and coronary artery calcium (CAC) share common lifestyle-related risk factors, yet their association in Chinese populations remains understudied. This study investigated how lifestyle factors influence the association between emphysema and CAC score in an urban Chinese general population. Methods: The study included 1000 participants from the Chinese Nelcin-B3 urban general population study originating in 2017 who underwent low-dose CT (LDCT) screening and comprehensive CT assessment. Emphysema was visually assessed by subtype and severity. CAC was measured using the Agatston method and categorized as 0, 1–100, and >100. Questionnaire-based lifestyle factors (smoking, BMI, diet, physical activity, alcohol consumption and environmental exposures) were categorized based on number of unfavorable behaviors. Multivariable multinomial logistic regression adjusted for age, sex, education and cardiovascular risk factors examined the associations between emphysema and CAC, with interactions and stratified analyses for lifestyle effects. Results: Emphysema was present in 62.3% of the participants, with centrilobular being the most common subtype (61.5%). Paraseptal emphysema was associated with both CAC 1–100 (OR: 2.07 [1.03–4.15]) and CAC > 100 (OR: 2.94 [1.26–6.84]). Severe emphysema was linked to CAC > 100 (OR: 3.50 [1.38–8.84]). These associations were stronger in the intermediate unhealthy lifestyle group for paraseptal (OR: 5.41 [1.70–17.22] and moderate and severe emphysema (OR: 9.64 [1.64–56.55]; OR: 3.73 [1.07–13.06]), respectively, but not significantly different. Conclusions: While paraseptal and severe emphysema are associated with higher CAC scores, there is no modifying effect of lifestyle factors. These findings suggest that cardiovascular risk assessment could be of importance in individuals with emphysema. Further longitudinal studies are needed to clarify the clinical implications. Full article

Background: Sustainable dietary transitions are increasingly emphasized in public health policy; however, validated psychometric instruments assessing knowledge, attitudes, and practices (KAP) in Asian contexts remain limited. Objectives: This study aimed to develop and evaluate a KAP questionnaire on sustainable diets and examine sociodemographic variations and behavioral correlates among Taiwanese adults. Methods: A two-phase mixed-methods design was used, including expert validation and a cross-sectional online survey (n = 587). Construct validity was examined using exploratory factor analysis, and reliability was evaluated through internal consistency and test–retest assessments. Multivariable logistic regression models were fitted to identify factors associated with low adherence to a low-carbon diet. Model diagnostics included variance inflation factors (VIF), Hosmer–Lemeshow tests, Nagelkerke pseudo-R², and ROC analysis. Results: Content validity was high (S-CVI/Ave = 0.95–0.98). The attitude and practice domains demonstrated satisfactory internal consistency, whereas the knowledge domain showed comparatively lower reliability. In multivariable logistic regression analyses, higher attitude scores were independently associated with lower odds of low adherence to a low-carbon diet. Eating-out frequency and clear awareness of sustainability in Taiwan’s Dietary Guidelines were also significantly associated with adherence. The fully adjusted model demonstrated adequate calibration and excellent discrimination (AUC = 0.778). Conclusions: The instrument provides preliminary psychometric evidence supporting the assessment of sustainable diet-related KAP among Taiwanese adults. Attitudes appear more strongly associated with dietary practices than knowledge alone. The questionnaire may support future monitoring and research. Full article