Search Results (118)

Eating behavior and eating habits are shaped from the earliest stages of life through interactions among biological, familial, social, and environmental factors. The aim of this narrative review is to integrate evidence on the early-life determinants of eating behavior and their influence on dietary intake from infancy to adolescence. A narrative review was conducted with a structured search approach prioritized on longitudinal studies, intervention trials, and policy evaluations when available, and using cross-sectional evidence mainly to describe patterns and sociodemographic factors. Synthesizing the current evidence, our framework proposes that breastfeeding, responsive complementary feeding, and self-regulatory parenting are associated with higher responsiveness to internal hunger, satiety cues, and preference for nutrient-dense foods. Conversely, coercive practices, early exposure to highly palatable foods, and the influence of food marketing are linked to dominant hedonic responses and impulsive consumption patterns. Furthermore, family environments characterized by stress or food insecurity, together with high access to low-nutrient foods, may increase vulnerability to poor eating habits and emotional eating during adolescence. Overall, the evidence highlights the need for preventive interventions that integrate parenting support, school food education, digital marketing regulation policies, and the promotion of healthy food environments across multiple sectors. Understanding the biological, psychological, and social factors linking early determinants to dietary intake and eating behaviors across development is essential for promoting a balanced relationship with food and preventing chronic diseases from an early age. Full article

Background/Objectives: Precision nutrition is moving beyond population-based guidance and isolated gene–diet interactions toward integrative models of dietary response. However, current approaches remain fragmented across nutrigenomics, microbiome research, multi-omics profiling, digital health, and machine learning. This review proposes the Nutri-Exposome Intelligence Framework as a conceptual, data science-driven model for integrating cumulative dietary, environmental, microbial, molecular, clinical, and digital exposures for precision chronic disease prevention. Methods: This conceptual review synthesizes the literature on precision nutrition, nutrigenetics, nutrigenomics, exposomics, gut microbiome research, multi-omics integration, wearable and biomarker-based monitoring, and machine learning in nutrition studies. Evidence was organized into a framework linking exposure assessment, host susceptibility, microbiome-mediated biotransformation, molecular response profiling, computational modelling, personalized intervention, and longitudinal feedback. Results: The proposed framework consists of seven interconnected layers: diet, environment, and lifestyle exposures; host genome and microbiome; multi-omics molecular responses; machine learning-based integration; risk prediction and responder stratification; personalized dietary intervention; and wearable and biomarker-based feedback. It positions the nutri-exposome as a cumulative exposure–response system and highlights how machine learning can support data harmonization, feature engineering, predictive modelling, responder classification, explainable interpretation, and adaptive refinement of dietary recommendations. Key applications include obesity, type 2 diabetes, cardiovascular disease, metabolic dysfunction-associated steatotic liver disease, cardiovascular–kidney–metabolic syndrome, and broader cardiometabolic prevention. Conclusions: Nutri-exposome intelligence offers a structured pathway for transforming complex nutrition data into predictive, explainable, and adaptive precision nutrition strategies. Implementation will require longitudinal and multi-ethnic cohorts, standardized metadata, causal validation, interpretable machine learning, ethical governance, and equitable access to support responsible clinical and public health translation globally. Full article

Breast cancer survivors frequently experience adverse changes in body composition, cardiometabolic biomarkers, functional capacity and quality of life that may worsen long-term prognosis, yet the comparative effectiveness of lifestyle interventions across delivery formats and supervision levels remains unclear. Background/Objectives: This systematic review assessed the effects of structured diet and exercise interventions on body composition, metabolic and inflammatory biomarkers, functional capacity, dietary habits and quality of life in breast cancer survivors. Methods: Following PRISMA guidelines, Cochrane, PubMed, Scopus and Web of Science were searched for randomized controlled trials and quasi-experimental studies published in English between 2016 and 2026. Risk of bias was assessed with RoB 2 and ROBINS-I and certainty of evidence with GRADE. Results: Of 1413 records, 15 studies (11 RCTs; mean age 46–60 years; mostly overweight or obese post-treatment women) met the inclusion criteria; twelve interventions were supervised and three home-based or web-based. Within the assessed domains, many studies reported significant improvements in body composition, quality of life and metabolic or inflammatory biomarkers. Effects were larger in multimodal supervised programs combining caloric restriction with moderate-to-vigorous aerobic plus resistance training (5–8% weight loss; 19–29% visceral fat reduction; improved insulin, IGF-1, leptin, adiponectin and EORTC QLQ-C30 scores), whereas digital or low-intensity interventions produced smaller, less uniform objective effects despite improving dietary behaviors. GRADE certainty ranged from very low to moderate–high. Conclusions: Multimodal supervised programs offer the most robust benefits; digital formats require additional supervision. Standardized protocols and longer follow-up are needed. Full article

Background/Objectives: This study aimed to evaluate the associations between MyFitnessPal usage, a widely used smartphone application, and weight management outcomes among U.S. adults, and to examine factors associated with clinically significant weight loss. Methods: Data from 1359 users who set weight loss goals and maintained consistent app engagement over 120 days were analyzed. Demographic characteristics, app engagement patterns, and dietary intake were compared between users who did and did not achieve clinically significant weight loss. Results: Nearly half (48.5%) of participants achieved clinically significant weight loss (≥5% of body weight), with success rates varying notably across age groups. App engagement was strongly associated with weight-loss success, with users maintaining detailed food logs achieving substantially higher success rates than the full cohort. Multivariable logistic regression identified daily app engagement as the significant predictor of weight-loss success, followed by lower carbohydrate intake, higher initial weight, and younger age. Conclusions: These findings indicate that greater engagement with MyFitnessPal is associated with favorable weight management outcomes and suggest that digital health platforms may be a scalable intervention for obesity prevention and treatment. Full article

Background: Diabetes is a growing public health crisis across the Arab region, where rapid urbanization, dietary transitions, and physical inactivity have contributed to some of the highest diabetes rates globally. Despite a growing recognition of the problem, most diabetes prevention efforts in the region remain small-scale or insufficiently adapted to the sociocultural realities of adults living in the UAE. Evidence-based diabetes prevention strategies, such as the United States’ Centers for Disease Control Diabetes Prevention Program (DPP), reduce the risk of developing diabetes but remain underutilized. Methods: The objectives of this study were to (1) describe the systematic cultural adaptation of the Evidence-based Intervention for Diabetes Prevention (EID) using the Framework for Reporting Adaptations and Modifications–Expanded (FRAME), and (2) assess the preliminary acceptability of the adapted materials through formative focus groups. Results: Materials were culturally tailored to address both deep and surface structures. Deep structure adaptations incorporated Arab cultural values, social norms, and religious practices, including Ramadan-specific content. The original 26-session curriculum was condensed to 12 weekly sessions based on prior research and stakeholder input. Surface-level adaptations included translation into Arabic and development of culturally relevant educational videos. Three formative focus groups (n = 7 total participants) provided preliminary findings of strong acceptability of simplified, culturally relevant, and digitally supported materials. Conclusions: This work will inform the adaptation of an evidence-based lifestyle change program aimed at preventing type 2 diabetes in high-risk individuals to better meet the needs of adults living in the UAE. While some countries have created their own national diabetes prevention efforts, like the United Kingdom, there is notably no similar program in the Arab world. Full article

Background: Nutritional literacy is a core competency for promoting healthy dietary behaviors and preventing nutrition-related chronic diseases. Standardized scales are essential for rigorous measurement and evaluation, yet the field exhibits substantial heterogeneity in concepts and measurement approaches. Methods: We systematically searched five major databases, namely Web of Science, PubMed, Scopus, Embase, and CINAHL, from their inception to October 2025. Evidence was compiled on the conceptual evolution, domain structure, scoring logic, population-specific applicability, and application scenarios of nutritional literacy scales. Results: A total of 14 nutritional literacy scales developed between 2005 and 2025 were included in the review. The structure and measurement content of these scales have progressively expanded, evolving from an early focus on basic reading and numeracy skills to become multidimensional assessment tools encompassing knowledge, skills, and behavioral practices. The target population has broadened from the general adult population to include multiple special groups, while application regions have extended from high-income Western countries to developing regions, including China and Turkey, and assessment methodologies have progressively shifted from single tests to blended objective–subjective approaches, with most scales demonstrating sound reliability and validity. These instruments are now employed for screening, intervention evaluation, dietary behavior mechanism research, and analysis of chronic disease risk. The reviewed studies indicate that nutritional literacy is generally positively correlated with healthy dietary behaviors, nutrition labeling utilization, and related health outcomes. Conclusions: Although nutritional literacy scale research has advanced with regard to conceptualization, measurement design, and applications, major gaps remain, including fragmented dimensional structures, insufficient standardization, inadequate cultural adaptation, and limited longitudinal evidence. Future work should prioritize a unified assessment framework, stronger tools for special and vulnerable populations, digital innovations for scalable measurement, and interdisciplinary and cross-national collaboration to enhance quality, practicality, and comparability and to support global nutrition promotion and public health policy. Full article

Background: Schools are widely recognized as key settings for promoting healthy eating behaviors and supporting childhood obesity prevention. In recent years, increasing attention has been devoted to experiential and interactive nutrition education strategies designed to actively engage children and adolescents in food-related learning processes. These approaches move beyond traditional didactic teaching and include practical and participatory formats, such as cooking activities, school gardening, digital or app-based learning tools, workshops and educational camps, and game-based learning interventions. Objective: This narrative review aims to provide an overview of experiential school-based nutrition education interventions, describing the main types of programs implemented in school settings and summarizing their reported effects on nutrition knowledge, attitudes, and eating behaviors among children and adolescents. Results: Across intervention studies and systematic reviews, hands-on and interactive educational models, including cooking classes, gardening programs, digital learning tools, workshops or camps, and board game-based interventions, frequently report improvements in nutrition knowledge, attitudes toward food, food-related skills, and self-efficacy. These programs seek to strengthen food literacy by combining experiential learning with educational content delivered within the school environment. Evidence regarding changes in dietary intake, diet quality, and anthropometric outcomes is more heterogeneous, with some studies reporting improvements in eating behaviors and others showing more modest or short-term effects. Program outcomes appear to be influenced by several contextual factors, including intervention duration, curriculum integration, teacher involvement, and the availability of resources supporting implementation. Conclusions: Experiential and interactive approaches represent an increasingly adopted strategy in school-based nutrition education. Their effectiveness appears to depend on the quality of implementation, the degree of integration within the school curriculum, and the broader educational context. Future research should further explore how different experiential formats can be optimally integrated into school systems to support the development of food literacy and sustainable healthy eating behaviors among children and adolescents. Full article

Background: Pediatric obesity (PO) is a chronic disease requiring multidisciplinary management. Recent clinical guidelines emphasize the need for accessible, patient-centered solutions, positioning mHealth interventions as vital “clinical extenders” in modern practice. Objective: This systematic review and meta-analysis evaluate the efficacy and evolution of mHealth interventions for PO management between 2020 and 2026. Methods: A systematic search of electronic databases identified randomized controlled trials (RCTs) investigating mHealth for PO. Quality was assessed using the Cochrane RoB 2 tool, and a meta-analysis was performed on a subset of studies reporting zBMI data. Results: Twenty-three RCTs met the inclusion criteria, of which six were included in the quantitative synthesis. The meta-analysis demonstrated a statistically significant reduction in BMI z-score (MD = −0.20; 95% CI: −0.36 to −0.04; p = 0.02), with moderate heterogeneity (I² = 60%; Q = 13.5, p = 0.019). Beyond anthropometric outcomes, mHealth interventions consistently improved behavioral parameters, including dietary quality and sedentary time. However, engagement declined over time in standalone digital interventions (“mHealth fade-out”), whereas hybrid models integrating human support demonstrated improved retention and sustained effects. Anthropometric and behavioral outcomes showed partially divergent trajectories, with behavioral improvements often preceding measurable changes in BMI, and data on body composition were rarely reported, limiting a more precise understanding of changes in adiposity beyond BMI. Conclusions: mHealth is an effective catalyst for obesity management when integrated into a multidisciplinary framework. Future protocols must prioritize developmental tailoring—targeting parental empowerment in early childhood and encouraging adolescent autonomy—to ensure sustained engagement and a clinical focus that looks beyond BMI. Full article

Background: Obesity is a major public health concern associated with adverse physical and psychological outcomes, including body shame (BS) and reduced self-esteem (SE). Lifestyle interventions incorporating dietary and exercise components, such as time-restricted eating (TRE), mindful eating, and structured physical activity, have shown promise; however, evidence on their combined effects within scalable, web-based formats remains limited. Objective: This study aimed to evaluate the effectiveness of a multi-component, web-based lifestyle intervention integrating TRE, mindful eating, and structured online exercise on body composition and psychological outcomes in young adults. Methods: In this pilot randomized controlled trial, 42 healthy young adults (age: 20.4 ± 1.6 years) were allocated to either an intervention group (n = 28) or a control group (n = 14). The intervention group followed an integrated program combining TRE, mindful eating principles, and guided online exercise sessions, while the control group received standard dietary and physical activity recommendations. Outcomes included body composition, anthropometric measures, BS (Weight- and Body-Related Shame and Guilt Scale), SE (Rosenberg Self-Esteem Scale), and eating behavior (Three-Factor Eating Questionnaire). Results: Significant group × time interactions were observed for body fat percentage (p < 0.001), fat mass (p = 0.001), and body mass (p = 0.025), with the intervention group demonstrating greater reductions compared with controls. BS scores significantly decreased in the intervention group, whereas no significant between-group differences were observed for SE (p > 0.05). Dietary adherence appeared higher than exercise adherence over the intervention period. Conclusions: A multi-component, web-based lifestyle intervention integrating TRE, mindful eating, and structured exercise may improve body composition and reduce BS in young adults. However, changes in SE were not observed over the short term. These findings support the feasibility of scalable digital lifestyle interventions, while highlighting the need for longer-term studies to clarify psychological outcomes. Full article

Background/Objectives: Dieting is a widespread behavior that is associated with psychological distress, body dissatisfaction, and eating disorders. Recent research suggests that a body-positive attitude and mindful approach to eating may influence individuals’ experiences with dieting; however, their combined role has been insufficiently explored. Methods: A two-phase study was conducted among voluntary adults using online data collection. In Phase 1, a cross-sectional survey was completed by 180 participants (71.7% women), assessing dieting behavior, body appreciation, nutritional awareness, psychological distress, well-being, and eating disorders. Correlation analyses, group comparisons, and regression models were performed. In Phase 2, 90 participants entered the pilot and received a brief psychoeducational digital material promoting mindful eating and positive body image. The follow-up assessment was completed by 59, after one month of engagement. Results: Body appreciation and nutritional awareness were positively associated with mental well-being and inversely related to psychological distress (p < 0.001 for all) and to eating disorder screening scores (p < 0.001 and p = 0.046, respectively). More frequent dieting was associated with lower body appreciation (p < 0.001). According to the observed pattern of correlations, body appreciation may play a role in the relationship between dieting and psychological distress. In the intervention phase, greater engagement with the psychoeducational material was associated with higher reported levels of nutritional awareness (p = 0.003) and greater perceived body awareness (p = 0.026) at follow-up; however, due to the exploratory design, findings are preliminary. Conclusions: The results suggest that dieting, as a behavior, may be embedded in broader psychological processes that include body-related attitudes and nutritional awareness. Taking these factors into account may have potential implications for preventive measures aimed at promoting healthier dietary habits, a more positive relationship with one’s body, and mental well-being. Full article

Diet quality, nutrition knowledge, and psychosomatic literacy—defined as the understanding of the interactions between diet, gut microbiota, and mental well-being—may shape weight-related behaviours in youth. This study used a cross-sectional design to integrate these domains with digital information pathways in Central–Eastern Europe. This study assessed diet quality, nutrition, and psychosomatic knowledge, supplement use, and health-information sources among Polish adolescents and young adults, with emphasis on age-related differences and the role of social media. A cross-sectional, anonymous online survey (October 2025–January 2026) was conducted in Poland (final analytical sample: n = 478; adolescents 15–19 years vs. young adults 20–30 years). Of 591 individuals who accessed the survey, 478 were included in the final analytical sample. Diet quality was estimated from FFQ data using KomPAN-derived indices (pHDI-10, nHDI-14, DQI). Nutrition knowledge (0–25 points), psychosomatic/gut–brain indicators, supplementation, and information sources were analysed using χ²/Fisher tests and Mann–Whitney U tests with effect sizes. The primary outcomes measured were dietary supplement use and excess body weight (BMI ≥ 25 kg/m²). Multivariable logistic regression examined predictors of supplement use and BMI ≥ 25 kg/m². Overall diet quality was low to moderate, with limited intake of whole grains, legumes, and fish, and common nutrition misconceptions. Social media was the most frequently indicated source of diet/supplement information and was independently associated with more frequent supplement use (OR = 2.29; 95% CI: 1.43–3.64). Adolescents reported lower whole-grain intake and more misconceptions than young adults. Predictors of BMI ≥ 25 kg/m² included male sex (OR = 2.46; 95% CI: 1.46–4.15), lower education, and lower nutrition knowledge, while age showed a non-linear positive association with excess body weight. Polish adolescents and young adults show gaps between declared pro-health attitudes and actual diet quality/competencies. Social media reliance appears particularly linked to product-oriented behaviours (supplementation). Prevention should strengthen nutrition and food safety education, digital health literacy, and professional guidance on supplementation, especially in adolescents. Our findings suggest that social media is a primary driver for dietary supplementation among Polish youth, more so than objective nutrition knowledge. While diet quality is linked to weight status, the relationship is complex. These results may inform future public health interventions targeting digital health literacy to promote balanced nutrition and safe supplementation practices. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disorder linked to obesity, insulin resistance, and dyslipidemia. Nutrition plays a central role in modulating hepatic lipid metabolism, oxidative stress, and inflammation, yet practical, evidence-based dietary strategies remain limited. This study aimed to develop Mediterranean diet-based meal plans with varying macronutrient compositions and to characterize their nutritional profiles, as well as to evaluate them using established nutritional indices and diet score calculations, such as the Dietary Inflammatory Index, Dietary Antioxidant Index, and dietary lipid indices. Methods: Clinical practice guidelines (CPGs) from various academic and professional organizations were reviewed to assess current non-pharmacological treatments for MASLD, with a focus on determining whether the Mediterranean diet is the most recommended dietary pattern. Traditional, low-carbohydrate, and low-fat MedDiet patterns were translated into food-based meal plans. A 7-day meal plan was developed and analyzed for nutrient composition, then evaluated using the Dietary Inflammatory Index (DII), Dietary Antioxidant Index (DAI), Dietary Lipophilic Index (DLI), and Dietary Lipophilic Load (DLL). A Western diet (WD) that is characterized by ultra-processed food (UPF) was included as a comparative reference. Results: The validated dietary score calculations showed that all MedDiet patterns demonstrated consistently low DII scores (−2.00 to −2.81) and high DAI scores (3 to 20.03), whereas the WD showed high DII scores (5.0 to 6.09) and low DAI scores (−12.47 to −17.99). Despite these variations in macronutrients, the menu developed in the study on three MedDiet patterns showed negative DII and positive DAI scores. When comparing the traditional MedDiet with the WD, which have similar macronutrient distributions, the WD was characterized by less favorable DII and DAI scores. Conclusions: This study provides a descriptive, guideline-informed framework for Mediterranean diet-based meal plans with varying macronutrient compositions. Utilizing DII, DAI, DLI, and DLL offers a potential framework for designing dietary interventions. Further validation through clinical studies is needed to justify the potential for practical and digital translation. Nevertheless, the study provides initial insights that may inform future research on nutritional approaches for MASLD integrating dietary indices. 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

Background/Objectives: In Italy, food waste within school meal services represents a major public health and sustainability challenge, with approximately 21.7% of meals discarded, and vegetables and legumes among the most frequently rejected components. Low consumption of these foods during childhood contributes to unhealthy dietary trajectories and increased long-term cardiometabolic risk. Evidence indicates that information-based nutrition education alone is insufficient to modify children’s eating behaviors within complex food environments. This study aimed to describe and evaluate the LO-VEg project, a school-based intervention designed to address dietary behavior and food waste simultaneously by integrating environmental nudging with child-centered communication strategies. Methods: The LO-VEg project was implemented as a quasi-experimental ecological school-based intervention combining environmental nudging strategies and multisensory communication tools to promote vegetable and legume consumption in primary school canteens. The intervention involved approximately 1500 pupils across four primary schools in the Lombardy region of Italy and was conducted over a 10-week period within routine school meal settings. Consumption outcomes were assessed through aggregated anonymous plate-waste observations collected during school meals. Results: Preliminary aggregated analyses indicated favorable trends in vegetable and legume consumption and plate-waste reduction during the intervention period. The broader intervention architecture also included communication, digital, and family-oriented components, which are described in the present manuscript as part of the implementation framework. Conclusions: The LO-VEg project suggests that integrating environmental nudging with child-centered communication strategies may represent a scalable approach to improving dietary behaviors and reducing food waste in school settings. Full article

Background: This structured narrative review summarizes and critically appraises evaluated childhood obesity prevention programs implemented in European countries and published between 2015 and 2024. Methods: Systematic searches for PubMed, EBSCOhost, and Google Scholar, complemented by research registries, were conducted year-by-year and independently screened by two reviewers. Results: Five multinational/international programs were identified alongside multiple national initiatives delivered in family, school, community, healthcare, and digital settings. Overall, interventions consistently improved intermediate outcomes—such as selected dietary behaviors, physical activity participation, knowledge, and parental self-efficacy—more than anthropometric endpoints. Effects on BMI/BMI z-score or overweight/obesity prevalence were heterogeneous and frequently small or non-significant, especially for short-duration, single-setting educational interventions. More favorable anthropometric outcomes were commonly reported in long-term, population-scaled physical activity or community-based programs as well as in multidisciplinary healthcare-supported approaches; however, these strategies were typically resource-intensive and sometimes showed differential effectiveness across socioeconomic or cultural groups. Conclusions: The evidence indicates that single-setting or short-term interventions may improve selected behavioral outcomes but are generally insufficient to produce sustained effects on anthropometric measures without integration into broader, multi-level strategies. It is needed to integrate families, schools, communities, and health services with explicit attention to sustainability and equity. Technology-supported tools may strengthen reach and continuity when embedded within comprehensive prevention frameworks. Full article