Search Results (707)

Introduction/Object: Gastrointestinal cancers are among the most common types of neoplasms and are often associated with malnutrition, which affects physical performance, treatment tolerance and prognosis. This paper aims to synthesize, through a systematic search, the evidence on the impact of nutritional interventions on nutritional status in patients with digestive cancers prone to malnutrition. Methods: A systematic search was performed in PubMed, MDPI, Web of Science and ScienceDirect, for articles published between 2009 and 2025. Overall, 14,503 records were identified, and after screening of titles, abstracts and full-text evaluation, 80 studies (cross-sectional and cohort) were included. Data extraction was performed by a single researcher, using pre-established criteria and a standardized table, and the assessment of study quality was performed qualitatively, taking into account study design, sample size, nutritional assessment methods and clarity of reporting of results. Results: Evidence suggests that individualized and early applied nutritional interventions contribute to maintaining weight and protein status, improve tolerance to oncological treatments and may positively influence patient survival. Conclusions: Nutritional therapy plays a crucial role in preventing complications and supporting the body during oncological treatment, optimizing patients’ quality of life. This review provides a clear synthesis of the current evidence and recognizes methodological limitations related to the qualitative assessment of the included studies. Full article

Pulmonary embolism (PE) is a potentially life-threatening cardiopulmonary condition that frequently requires hospitalization and is often accompanied by reduced mobility, systemic inflammation, and nutritional impairment. These factors may contribute to the development or worsening of sarcopenia, a condition associated with adverse outcomes in hospitalized patients. However, its clinical relevance in patients with PE has not been sufficiently explored. This longitudinal observational cohort study evaluated the association between sarcopenia and clinical outcomes in patients hospitalized with confirmed PE. Participants were classified according to the presence of sarcopenia based on muscle mass and muscle strength criteria. Symptom severity, functional status, and health-related quality of life were assessed at hospital admission, at discharge, and three months after discharge. A total of 162 patients were included. Patients with sarcopenia exhibited a greater symptom burden, poorer functional status, and worse self-perceived health compared with non-sarcopenic patients. At discharge, sarcopenic patients reported higher levels of dyspnea and fatigue, poorer health-related quality of life, and experienced longer hospital stays. At the three-month follow-up, these patients continued to show significantly worse symptoms, reduced functionality, and lower quality of life. Sarcopenia was therefore associated with a persistently worse clinical and functional profile in patients hospitalized for PE. Early identification of sarcopenia may help identify patients at higher risk of poor recovery and support the implementation of targeted interventions aimed at improving functional outcomes and quality of life. Full article

Background: Early childhood caries (ECC) compromise the nutrition, growth, and quality of life in young children, and their relationship with breastfeeding practices remains disputed. Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children aged under 71 months. Material and Methods: A systematic review of PubMed, Multidisciplinary Digital Publishing Institute, and Evidence-Based Dentistry, was conducted through August 2025, including observational studies, randomized trials, narrative reviews, and meta-analyses on breastfeeding and ECC. Results: Thirty-one studies involving 28,000 children were included. Exclusive breastfeeding for under six months halves ECC probability (OR 0.53–0.58), whereas breastfeeding beyond 12 months and nocturnal feeds increase probability by 60–86% (OR 2.35–7.14). Parental factors—high plaque levels, feeding-to-sleep, and skipped post-feed cleaning—strongly predict ECC (OR 8.51–75.6). Interventions combining feeding counseling with home visits or visual aids reduce ECC incidence by 22–32% (RR 0.68–0.78). Conclusions: Exclusive breastfeeding through six months is protective against ECC, but prolonged or nocturnal feeding heightens risk. Integrating structured oral health education into breastfeeding promotion is recommended. Full article

Small pelagic fish, including sardines, are essential to global fisheries and aquaculture feed production. However, these species are increasingly exposed to intense exploitation. In Chile, the common sardine (Strangomera bentincki), endemic to the Humboldt Current System, supports major industrial and artisanal fisheries. Landings are expected to reach 300,000 tons by 2025, mostly for fishmeal production. As a keystone species, S. bentincki is highly sensitive to environmental variability during early development, which can reduce recruitment and threaten long-term population sustainability. This interdisciplinary approach integrates ecological and biotechnological perspectives to assess the feasibility of controlled juvenile sardine production in land-based Ecological Aquaculture (EA) systems, including Recirculating Aquaculture Systems (RAS) and Integrated Multi-Trophic Aquaculture (IMTA), which are designed to reduce environmental impacts. These systems enable precise control of temperature, feeding regimes, and water quality, facilitating investigations into larval and juvenile survival, growth performance, and physiological responses under variable thermal and nutritional conditions. Emphasis is placed on fatty acid metabolism during ontogeny, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are essential for somatic growth, reproductive development, and thermal tolerance. Developing standardized protocols for juvenile S. bentincki culture addresses key gaps in husbandry and physiology (temperature threshold, nutrient density, larval growth rate, etc.) while introducing a novel ecological–aquaculture integration framework. This approach links early-life ecology with applied rearing techniques to support stock enhancement, strengthen artisanal fisheries, and promote sustainable aquaculture diversification under increasing environmental variability. Full article

Background/Objectives: The first 1000 days of life represent a critical window for growth and neurodevelopment, during which nutrition strongly influences brain development and metabolic programming. In phenylketonuria (PKU), dietary management is essential to prevent neurological impairment and later-life risk of non-communicable diseases (NCDs). This review examines current evidence on PKU from pregnancy through complementary feeding, highlighting the impact of nutritional strategies on neurodevelopmental and metabolic outcomes. Methods: This narrative review, following PRISMA guidelines, used a systematic search of PubMed and Scopus with defined PICO questions. Original research, reviews, and guidelines on PKU nutrition during the first 1000 days were included, emphasizing neurological and metabolic outcomes. Results: Articles addressed prenatal and postnatal factors in PKU. Optimised metabolic control in women with PKU is critical to prevent maternal PKU syndrome, reducing risks of miscarriage, congenital heart defects, microcephaly, and neurocognitive impairment. Pre-conception dietary management, frequent blood Phe monitoring, supplementation with Phe-free protein substitutes (PSs), micronutrients, and emerging pharmacological therapies support maternal and foetal health. Following newborn screening, early dietary treatment in infants with PKU maintains plasma Phe within safe ranges, promoting growth and neurodevelopment. Breastfeeding, combined with Phe-free infant PSs, is feasible, and complementary feeding should be introduced carefully. Frequent monitoring and tailored dietary adjustments, including second-stage PSs, support metabolic control, while data on gut microbiota remain limited. Conclusions: Early multidisciplinary interventions are crucial to optimise metabolic and neurodevelopmental outcomes during this window of opportunity. Further research is needed to address remaining gaps and optimise PKU management across the first 1000 days. Full article

Background: Gestational diabetes mellitus (GDM) is a frequent pregnancy pathology with poor maternal and fetal outcomes and risk of type 2 diabetes in later life. Despite known risk factors, such as obesity, age, and familial history, new data suggest that environmental exposure to agents, such as pesticides, can play a role in the etiogenesis of GDM. Objective: The epidemiologic, experimental, and mechanistic evidence between pesticide exposure and GDM risk is summarized here, and we concentrate on recent research (2000–2025). Methods: We conducted a literature search in PubMed, Embase, and the Cochrane Library for studies published from January 2000 to December 2025 using combinations of the terms “fertilizers”, “herbicides”, and “pesticides” with “diabetes mellitus” and “gestational diabetes”. After deduplication, 12 unique studies met inclusion criteria for qualitative synthesis (GDM endpoint or pregnancy glycemia with pesticide exposure). Results: Occupational and agricultural exposure to pesticides during first pregnancy was determined to be associated with a significantly increased risk of GDM through various epidemiologic studies. New studies have implicated new classes of pesticides, including pyrethroids and neonicotinoids, with higher GDM risk with first-trimester exposure. Experimental studies suggest that pesticides provide potential endocrine-disrupting chemicals that can induce insulin resistance through disruption of hormonal signaling, oxidative stress, inflammation, β-cell toxicity, and epigenetic modifications. However, significant limitations exist. Most of the evidence is observational, measurement of exposure is often indirect, and confounding factors are difficult to exclude. Notably, low dietary and residential exposure is not well studied, and dose–response relationships are undefined. Conclusions: New data indicate that pesticide exposure during early pregnancy and occupational exposure may increase the risk of GDM. Prospective cohort studies using biomonitoring, chemical mixture exposure, and geographic variation in pesticide exposure should be the focus of future research. Due to potential public health implications, preventive strategies to ensure the quality of nutrition and to reduce maternal exposure to pesticides during pregnancy are rational. Full article

Background and Objectives: Retinopathy of prematurity (ROP) remains a leading cause of preventable childhood blindness, with its severity influenced by a complex interaction between nutritional status, metabolic maturation, and systemic vulnerability. This study aimed to evaluate whether early nutritional patterns and serum metabolic parameters, including hepatic and renal biomarkers, are associated with ROP severity and whether they may serve as potential predictors of disease progression. Materials and Methods: We conducted a retrospective study on 140 preterm infants, totaling 280 eyes, admitted between 2021 and 2024 in two neonatal intensive care units (NICU). Each eye was analyzed independently according to International Classification of Retinopathy of Prematurity (ICROP) criteria. Data on the timing of enteral feeding, duration and type of nutrition, and serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein, blood glucose, urea and creatinine were collected throughout the first 28 days of life. Statistical analysis included Kruskal–Wallis and Chi-square tests, with a significance threshold of p < 0.05. Results: ROP was identified in 53.57% of cases. Enteral feeding began earlier in infants without ROP, whereas delayed initiation and prolonged parenteral nutrition were associated with more advanced stages. Natural feeding decreased with increasing severity and was absent in aggressive retinopathy of prematurity (A-ROP). Severe disease stages showed higher AST, ALT, urea and creatinine levels, along with lower early total protein values. Glycemic instability was observed more frequently in stage 2 and stage 3. Conclusions: Early nutritional support, especially early enteral feeding and natural feeding, appears protective against ROP progression. Hepatic, renal and glycemic metabolic changes are closely correlated with disease severity, indicating that metabolic balance reflects overall vulnerability in preterm infants. Incorporating nutritional and metabolic assessment into routine screening may enhance early risk identification and optimize clinical monitoring. Full article

Early-life development of immune functions is crucial for calf health, growth, and future productivity. Galacto-oligosaccharides (GOSs) have been reported to facilitate ruminal microbial establishment and improve growth in Holstein dairy calves, but their prolonged influence on immunoglobulin levels, hindgut microbiota, and metabolic regulation remains insufficiently understood. This study evaluated the effects of early-life GOS supplementation on immune-related indicators, intestinal microbial ecology, and metabolic profiles in Holstein calves. Twenty-four newborn Holstein female dairy calves were randomly assigned to a control group (CON, n = 12) or a GOS group (GOS, n = 12; 10 g/day from birth to day 28). After supplementation ceased on day 28, calves previously receiving GOS were referred to as the GOSS group (n = 6). Immunoglobulin levels, gut microbiota, and fecal and serum metabolomes were evaluated during supplementation and six weeks after withdrawal. GOS supplementation significantly increased serum IgA and IgG levels during the treatment, with IgG levels remaining elevated for six weeks after discontinued supplementation. Although overall microbial diversity was not markedly altered, GOS selectively enriched bacterial taxa and function pathways linked to amino acid synthesis, unsaturated fatty acid production, and coenzyme-related metabolism. On day 70, GOSS group displayed distinct fecal and serum metabolomic profiles, with altered metabolites primarily associated with vitamin B6, folate, cobalamin metabolism, branched-chain amino acid biosynthesis, and purine and arginine pathways. These results demonstrate that early-life GOS supplementation promotes sustained immune and metabolic alterations following supplementation cessation, potentially mediated by modulation of gut microbial functions. These findings suggest that early dietary GOS supplementation may support physiological maturation in calves and could be useful as a nutritional strategy in calf-rearing systems. Full article

Post-dialysis fatigue is one of the most frequent and limiting symptoms among patients undergoing hemodialysis (HD), characterized by intense physical exhaustion that may persist beyond the treatment session. Sleep disturbances frequently coexist with fatigue and may contribute to overall symptom burden. Nutritional status has been identified as a potential determinant of fatigue severity. Understanding these relationships may help identify associated factors and guide multidisciplinary interventions. Objectives: To assess the prevalence and intensity of fatigue in patients receiving HD, to describe the burden of sleep disturbances, and to analyze their association with nutritional status and various clinical, dialytic, and sociodemographic variables. Methods: A cross-sectional descriptive study was conducted between November and December 2024 in adults with chronic kidney disease undergoing maintenance HD. Fatigue and sleep disturbances were assessed using brief patient-reported outcome items adapted from PROMIS item bank concepts and analyzed as separate subscales. Nutritional status was evaluated using the Mini Nutritional Assessment–Short Form (MNA-SF). Sociodemographic, clinical, dialytic, and laboratory variables were collected. Statistical analyses were performed using SPSS v29, applying association and correlation tests (p ≤ 0.05). Results: A total of 729 patients were included (67.1% men), with a mean age of 67.7 ± 14.5 years. Clinically relevant fatigue was reported by approximately 50% of participants, with around 20% presenting severe fatigue. Sleep disturbances affected nearly 60% of patients, with severe impairment reported in approximately 30%. Regarding nutritional status, 61.9% had normal nutrition, 33.2% were at risk of malnutrition, and 4.9% were malnourished. Fatigue was significantly associated with female sex (p < 0.001), longer time on hemodialysis (p < 0.001), greater weekly dialysis exposure (p = 0.012), and poorer nutritional status (p = 0.003). The absence of residual urine output showed a borderline association with fatigue (p = 0.059) but was significantly associated with sleep disturbances (p = 0.002). Sleep disturbance scores were also significantly associated with lower levels of albumin, total proteins, and transferrin. No associations were observed between fatigue and age, BMI, comorbidity, ultrafiltration rate, or biochemical parameters. Conclusions: Fatigue is a highly prevalent and clinically relevant symptom in patients undergoing HD and is closely associated with nutritional status and dialysis-related factors. Sleep disturbances are also highly prevalent and may act as an important modulating factor, potentially amplifying fatigue, particularly in patients with greater biological vulnerability or loss of residual kidney function. The systematic use of patient-reported outcome measures (PROMs) to assess fatigue and sleep, together with nutritional evaluation, may facilitate the early identification of vulnerable patients and guide targeted strategies to reduce symptom burden and improve quality of life. Full article

Background/Objectives: Gestational exposure to a high-fat diet (HFD) reprograms hypothalamic orexigenic circuits prenatally. However, whether astrocytes, critical modulators of this system, are also imprinted by HFD in the fetal brain remains unknown. We investigated the impact of HFD on the prenatal neuroglial architecture of the lateral hypothalamic area (LHA). Methods: Female Wistar rats were fed a control or a 60% fat diet for 12 weeks. Upon reaching obesity (Lee index ≥ 310), dams were mated. Fetuses were harvested via cesarean section at term, and their brains were processed for immunohistochemistry and morphometry to assess cell proliferation, orexin neuron density, and astrocytic reactivity in the LHA. Results: HFD significantly increased cell proliferation and orexinergic neuron density, and induced early signs of astrocyte reactivity in the fetal LHA. These findings reveal that both neuronal and glial components of the LHA orexigenic axis are structurally reprogrammed before birth. Conclusions: This study provides the first evidence that HFD simultaneously alters neuronal and glial developmental trajectories in the fetal hypothalamus. The concurrent programming of astrocytes and orexigenic neurons suggests a prenatal origin for neuroinflammatory susceptibility, reframing obesity as a neurodevelopmental disorder shaped by early life nutritional environments. Full article

Autism spectrum disorder (ASD) arises from complex genetic and environmental influences. Despite its prevalence and being the focus of study for several decades, its causes and their underlying mechanisms are still not fully understood. However, one consistent causal mechanism of interest is epigenetic modification. While some risk factors, such as maternal stress, nutrition, and environmental toxins, have a more established epigenetic connection, early-life stress (ELS) in the postnatal years is less studied but may be just as impactful in terms of phenotypic outcomes. A major intermediary between ELS and ASD is likely the hypothalamic–pituitary–adrenal axis (HPA axis), which has been shown to be epigenetically modified by ELS and whose genes and dysfunction overlap with ASD genes and symptoms. In this narrative review, we synthesize human and animal evidence to examine the relationships between ELS and ASD through epigenetic regulation of a non-exhaustive list of autism candidate genes involved in the HPA axis, including NR3C1, FKBP5, MECP2, GAD1, RELN, SHANK3, OXTR, and BDNF. We discuss how ELS-induced epigenetics may modulate HPA axis negative feedback, and how epigenetic alterations in this pathway and associated genes could affect ASD phenotypes. Full article

The prevalence of food allergy continues to rise worldwide. The allergen profile of affected individuals changes with age: milk, egg, wheat, and soy allergies are more common in early childhood and often resolve before adolescence, whereas peanut, tree nut, fish, and shellfish allergies tend to persist and become more apparent in teenagers. The aim of this narrative review is to discuss the impact of food allergy and elimination diets on the nutritional status, psychological functioning, and quality of life of adolescents. Although an elimination diet remains the main way of treatment, it may lead to the risk of vitamin D, calcium, iron, and protein deficiencies, and potentially to growth disorders. In adolescents, irregular eating habits and poor adherence to dietary recommendations pose additional challenges. The psychological burden of living with food allergy include fear of accidental contact with the allergen, difficulties in peer relationships, and reduced quality of life, particularly in terms of social and emotional functioning. Lack of training in using an adrenaline autoinjector and embarrassment about its use are further risk factors in this age group. Optimal care for adolescents with food allergies requires a multidisciplinary approach, including an allergist, dietitian, and psychologist. Education, psychological support, and gradual development of self-management skills are crucial to improving the safety and quality of life of adolescents with food allergies. Further efforts by medical societies are warranted to advance the development of alternative therapeutic approaches for food allergy, including immunotherapy and biologic therapies, as well as to strengthen public health strategies for individuals affected by food allergies. Full article

Background: Inadequate nutrition, poor health care, and limited stimulation constrain early childhood development and cognitive potential. Micronutrient deficiencies during pregnancy and early life are prevalent in low- and middle-income countries (LMICs) and may impair cognitive outcomes. Maternal multiple-micronutrient (MMN) and point-of-use micronutrient powder (MNP) supplements improve birth outcomes and iron status, but their long-term cognitive impact remains unclear. This systematic review assessed the long-term impact of maternal MMN and early-childhood MNP supplementation on cognitive development among children aged 4–14 years in LMICs. Method: Following PRISMA guidelines (PROSPERO CRD42023459846), (cluster) randomized controlled trials were identified from six databases and gray literature (October 2023; updated July 2025). Records were managed in EndNote and screened in Covidence, and data were synthesized using Review Manager. Eligible studies examined MMN or MNP interventions during pregnancy, lactation, or early childhood, reporting cognitive, motor, or socio-emotional outcomes in children aged 4–14. Results: Ten studies met the inclusion criteria: six on maternal supplementation, three on early childhood interventions, and one combining both. Most were conducted in Asia, with one in Tanzania and one in Peru. Although most findings were not statistically significant, two large UNIMMAP-based trials indicated modest long-term improvements in procedural memory and intelligence, while one early childhood point-of-use MNP trial suggested enhanced pre-academic skills. Conclusions: Maternal MMN supplementation may modestly enhance specific domains of cognitive development, whereas evidence on the long-term effects of MMN and point-of-use MNPs on cognitive development remain limited, highlighting the necessity for further research. Full article

In animals and humans, nutrients influence signaling cascades, transcriptional programs, chromatin dynamics, and mitochondrial function, collectively shaping traits related to growth, immunity, reproduction, and stress resilience. This review synthesizes evidence supporting nutrient-mediated regulation of DNA methylation, histone modifications, non-coding RNAs, and mitochondrial biogenesis, and emphasizes their integration within metabolic and developmental pathways. Recent advances in epigenome-wide association studies (EWAS), single-cell multi-omics, and systems biology approaches have revealed how diet composition and timing can reprogram gene networks, sometimes across generations. Particular attention is given to central metabolic regulators (e.g., PPARs, mTOR) and to interactions among methyl donors, fatty acids, vitamins, and trace elements that maintain genomic stability and metabolic homeostasis. Nutrigenetic evidence further shows how genetic polymorphisms (SNPs) in loci such as IGF-1, MSTN, PPARs, and FASN alter nutrient responsiveness and influence traits like feed efficiency, body composition, and egg quality, information that can be exploited via marker-assisted or genomic selection. Mitochondrial DNA integrity and oxidative capacity are key determinants of feed conversion and energy efficiency, while dietary antioxidants and mitochondria-targeted nutrients help preserve bioenergetic function. The gut microbiome acts as a co-regulator of host gene expression through metabolite-mediated epigenetic effects, linking diet, microbial metabolites (e.g., SCFAs), and host genomic responses via the gut–liver axis. Emerging tools such as whole-genome and transcriptome sequencing, EWAS, integrated multi-omics, and CRISPR-based functional studies are transforming the field and enabling DNA-informed precision nutrition. Integrating genetic, epigenetic, and molecular data will enable genotype-specific feeding strategies, maternal and early-life programming, and predictive models that enhance productivity, health, and sustainability in poultry production. Translating these molecular insights into practice offers pathways to enhance animal welfare, reduce environmental impact, and shift nutrition from empirical feeding toward mechanistically informed precision approaches. Full article

Neuroendocrine neoplasms (NENs) are rare and heterogeneous tumors with heterogeneity in morphology and molecular profile and consequently resulting in a heterogeneous biological behavior. They have a more indolent natural history compared to the classic cancer and may emerge in any site of the human body, but usually they have gastroenteropancreatic (GEP) or bronchopulmonary (BP) origin. When NENs are well differentiated, they are called neuroendocrine tumors (NETs) as opposed to poorly differentiated neuroendocrine carcinomas (NECs). They may secrete a bioactive molecule resulting in a secretory syndrome or they may not be associated with any secretory product, defining functional and non-functional NENs. The hormonal hypersecretion syndromes, the chronic symptom burden, the tumor-related inflammation, and the treatment side effects impair nutritional intake and absorption while increasing metabolic needs. The present comprehensive narrative review is summarizing established and emerging methods of nutritional and body composition assessment, and the recent evidence of interventions for sarcopenia and malnutrition in patients with NETs. Early identification and management of malnutrition and sarcopenia are fundamental steps to improve quality of life and clinical outcomes in these patients during the long natural history of these neoplasms. Full article