Search Results (1,704)

Background/Objectives: Sleep disturbances are highly prevalent in young individuals with eating disorders (EDs) and are associated with increased psychopathology and poorer clinical outcomes. However, sleep alterations in ED populations are heterogeneous and may reflect distinct underlying clinical profiles. The study aimed to identify sleep quality profiles and examine their clinical correlates in youth with EDs. Methods: A total of 288 youth outpatients with EDs completed the Pittsburgh Sleep Quality Index (PSQI), along with measures of eating and general psychopathology. Latent Profile Analysis (LPA) was conducted using PSQI scores to identify distinct sleep profiles. Multinomial logistic regression models were performed to assess clinical variables of profile membership. Results: A four-profile solution was identified: (1) less impaired sleepers, (2) medication-using sleepers, (3) global poor sleepers, and (4) sleep-initiation-difficulty sleepers. Profiles differed significantly in ED severity, affective symptoms, emotion regulation difficulties, and sleep-related eating behaviors. Profiles characterized by greater sleep impairment exhibited higher levels of binge eating, night eating, and psychological distress. Multinomial logistic regression analyses indicated that night eating was the largest contributor to latent profile membership across all comparisons, significantly increasing the likelihood of belonging to more impaired sleep profiles. Conclusions: Sleep in individuals with EDs is characterized by distinct and clinically meaningful profiles rather than a uniform pattern of impairment. These findings support the clinical utility of person-centered approaches to better characterize sleep disturbances in ED populations. Full article

The increasing demand for better fruit flavor and eating quality has driven the need for rapid and non-destructive assessment of internal attributes to support fruit grading and precision supply. Visible–near-infrared hyperspectral imaging (VNIR-HSI) provides rich spectral–spatial information for evaluating sweetness in citrus fruit, but its practical use is constrained by high spectral dimensionality, redundancy, and system cost. Here, we propose a reconstruction-assisted, attention-guided band-selection framework for non-destructive prediction of soluble solids content (SSC) in Shimen honey mandarins. The framework integrates spectral–spatial attention, probability-based differentiable band selection, and full-band reconstruction into a unified end-to-end architecture, enabling compact and informative band learning. Using 952 samples, the model selected 56 informative bands from the original 176-band hyperspectral data and achieved competitive SSC prediction on the test set (RMSE = 0.63 °Brix, R² = 0.80) while maintaining high-fidelity reconstruction of the full-band hyperspectral cube from the compact input (peak signal-to-noise ratio, PSNR = 36.47 dB; structural similarity index, SSIM = 0.89). These findings support the proposed framework as a methodological proof of concept for non-destructive citrus quality evaluation, indicating that substantial spectral compression can be achieved under the current VNIR setting while largely preserving predictive performance. The selected bands may provide candidate spectral regions for future compact citrus-quality sensing systems. Full article

Background/Objectives: To assess the prevalence of eating disorder (ED) risk in a sample of Italian university students and to examine its independent associations with mental health indicators, self-rated health, body mass index (BMI), lifestyle behaviours, and engagement with digital food-related applications. Methods: Of the 2779 Italian university students who accessed the survey, 2691 completed and were included in the analysis. ED risk was assessed with the validated 5-item SCOFF questionnaire. Exposure included socio-demographics, BMI, depressive symptoms (PHQ-9), self-rated health, adherence to the Mediterranean diet (Medi-Lite), smoking, alcohol use (AUDIT-C), and use of food delivery and food waste apps. Multivariable logistic regression models, stratified by sex, and adjusted by age and education, estimated associations with ED risk. Results: Overall, 34.6% of participants screened positive for ED risk (women 39.5%, men 21.8%). Smoking and use of food delivery apps and food waste apps were independently associated with ED risk. Clinically relevant depressive symptoms (PHQ-9 ≥ 10) (aOR 3.37, 95% CI 2.82–4.02) and poor/fair self-rated health (aOR 2.45, 95% CI 1.93–3.11) showed the strongest association. Overweight (aOR 1.47, 95% CI 1.06–2.03) and obesity (aOR 2.48, 95% CI 1.53–4.01) increased the likelihood of ED risk. Risky alcohol use was also associated (aOR 1.42, 95% CI 1.15–1.75). Conclusions: More than one in three Italian university students is at risk for an ED, highlighting a substantial public health concern. Strong links with depression, perceived poor health, digital food app use, and unhealthy behaviours underscore the need for early screening and integrated mental health and nutrition interventions within university settings. Full article

Background/Objectives: Existing literature has consistently identified perfectionism as a core feature of anorexia nervosa (AN). However, much of the research has focused primarily on its association with eating disorder-related symptoms. At the same time, less attention has been paid to understanding how perfectionism affects the overall psychological functioning of individuals with eating disorders, and in particular AN. The present study aimed at investigating the association between perfectionism and both eating disorder-specific symptomatology and general psychological symptoms in a sample of young adult Italian women diagnosed with AN. Methods: Thirty-five Italian females diagnosed with AN (mean age ± SD: 21.9 ± 4.18 years; mean body mass index: body mass index ± SD: 14.5 ± 1.77 kg/m²) were consecutively recruited at the Division of Eating and Nutrition Disorders, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, a third-level clinical centre for the rehabilitation of obesity and eating disorders located in northern Italy. Once informed about the research, screened for inclusion/exclusion criteria, and enrolled, participants were asked to complete the Eating Disorder Inventory—third edition, the Symptoms Checklist-90 revised, and the Frost Multidimensional Perfectionism Scale to collect demographic and clinical variables of interest for the study. Three hierarchical linear regression models were tested to explore the role of perfectionism in both eating disorder-specific symptomatology and general psychological symptoms. Results: The analyses showed a significant influence of perfectionism in all tested models, suggesting that perfectionism was significantly associated with both eating disorder-specific symptomatology and general psychological symptoms in a sample of young adult Italian women diagnosed with AN. Conclusions: The findings of this study provide further support for the role of perfectionism in the psychopathology of eating disorders, particularly among young adult women with AN. Consistent with prior research, perfectionism was associated with both disorder-specific symptoms and broader psychological symptoms. Notably, its association remained robust even after controlling for key variables such as age and body mass index, underscoring its potential as an independent risk factor. Full article

Binge-eating disorder (BED), defined as recurrent episodes of consuming large amounts of food in a short period of time while experiencing a loss of control, remains difficult to manage. Although several pharmacological options are available, they often provide limited long-term benefit and may cause adverse effects. Emerging evidence suggests that gut microbiota dysbiosis contributes to BED pathophysiology. Cytokine infiltration of the gut barrier ultimately causes neuroinflammation, highlighting the gut–brain axis as a potential therapeutic target. This systematic review and meta-analysis evaluated the effectiveness and safety of central nervous system-targeting pharmacotherapies and psychobiotics for BED. Cochrane Library, PubMed, and the Virtual Health Library were searched for randomized controlled trials published from January 2000 to January 2026. Eligible studies evaluated monotherapy with a central nervous system-acting drug or psychobiotics in clinically diagnosed BED populations. Twenty pharmacological trials (n = 2154) and five psychobiotic trials (n = 304) met the inclusion criteria. Risk of bias was assessed using the Cochrane RoB 2 tool, and pooled estimates were calculated using random-effects models. Pharmacological interventions showed a significant pooled effect versus placebo (Standard Mean Difference (SMD) = 0.307, 95% Confidence Interval (CI): 0.103–0.511, p = 0.003), although heterogeneity warrants cautious interpretation. Psychobiotics showed a moderate and significant effect (SMD = 0.680, 95% CI: 0.448–0.913; I² (heterogeneity index) = 0%) and no reported adverse events. Overall, our study implies that psychobiotics may be a safe and potentially effective adjunctive approach for BED, but larger, well-designed trials are needed. Full article

Background/Objectives: Dyslipidemia is a major cardiometabolic disorder frequently accompanied by adverse fat distribution and unhealthy eating behaviors. This study aimed to compare meal pattern characteristics and anthropometric indicators between adults with newly diagnosed dyslipidemia and normolipidemic controls and to identify factors independently associated with dyslipidemia. We hypothesized that breakfast skipping would be more prevalent among individuals with dyslipidemia and that distribution-based anthropometric markers—particularly neck circumference (NC) and waist circumference (WC)—would be more strongly associated with dyslipidemia than body mass index (BMI). Methods: This cross-sectional comparative study included 257 adults without diabetes aged 18–65 years. Anthropometric assessment included BMI, WC, waist-to-height ratio (WHtR), and NC. Meal patterns were assessed using a structured questionnaire. Hierarchical binary logistic regression was used to identify independent associations. The linearity assumption was verified, and a sensitivity analysis was performed with HbA1c dichotomized at ≥5.7%. Results: Elevated NC was more frequent in participants with dyslipidemia (95.6% vs. 78.3%, p < 0.001). Breakfast skipping was more common among participants with dyslipidemia (30.7% vs. 15.0%, p = 0.003), whereas lunch skipping was less common (52.6% vs. 65.8%, p = 0.031). In the fully adjusted model, elevated NC (OR: 4.72), breakfast skipping (OR: 3.39), and HbA1c (OR: 3.61) were independently associated with dyslipidemia. These findings were confirmed in sensitivity analysis. Conclusions: Breakfast skipping and elevated NC were independently associated with newly diagnosed dyslipidemia, partially supporting the study hypothesis. Breakfast skipping and NC may aid in early risk identification in outpatient settings. Prospective studies are needed to confirm these associations. Full article

Objectives: This study’s main objective was to examine the association between dietary greenhouse gas emissions (GHGEs) and diet quality among U.S. primary and secondary schoolchildren. Our secondary objectives were to identify demographic characteristics associated with higher-GHGE diets and to assess the relationship between school meal consumption and dietary GHGE. Methods: We conducted a cross-sectional secondary analysis of dietary intake data from 2165 primary and secondary students participating in the nationally representative 2014–2015 US School Nutrition and Meal Cost Study (SNMCS). Dietary GHGEs (kg CO₂-equivalents per 1000 kcal) were estimated by linking reported foods to an environmental impact database. Diet quality was assessed using the Healthy Eating Index-2010 (HEI). Students were categorized into GHGE groups, and differences in total HEI and component scores were examined using appropriate statistical tests. Statistical significance was set at p < 0.05. Results: The average dietary GHGE of the sample was 3.64 kg CO₂-equivalent per person per day. Overall, HEI scores did not differ between the GHGE groups (p = 0.22). However, compared to the high-GHGE group, the low-GHGE group scored significantly higher on some HEI-2010 components, such as fatty acid ratios (p < 0.0001) and sodium (p < 0.0001), and significantly lower on others, such as dairy (p < 0.0001), total protein foods (p < 0.0001), and refined grains (p < 0.0001). Male students and students who ate school meals on the day of recall had higher odds of being in the high-GHGE group compared with their respective reference groups. Conclusions: Lower dietary carbon footprints are achievable without sacrificing overall diet quality, but tradeoffs in specific dietary components indicate the need for additional research and care in recommending diet changes or setting school policies. Full article

Background: Anorexia nervosa (AN) commonly emerges during adolescence and disproportionately affects girls. In recent years, problematic social media use (PSMU) has been identified as a potential sociocultural risk factor for eating disorder symptoms; however, the psychosocial pathways linking PSMU to AN symptomatology remain insufficiently understood. This study examined the associations between PSMU and AN symptoms in adolescent girls and explored the roles of perceived parenting style and childhood traumatic experiences as explanatory pathways. Methods: A cross-sectional, school-based survey was conducted with 463 adolescent girls aged 13–18 years in İstanbul, Türkiye. Participants completed validated self-report measures assessing AN symptoms (Eating Attitudes Test–26), problematic social media use (Social Media Disorder Scale), perceived parenting style (Parenting Styles and Dimensions Questionnaire), and childhood trauma (Childhood Trauma Questionnaire). Structural equation modeling was used to examine direct and indirect associations between PSMU and AN symptoms, controlling for age, body mass index, and socioeconomic indicators. Indirect effects were tested using bias-corrected bootstrapping. Results: Problematic social media use was directly associated with greater AN symptom severity (β = 0.18, p < 0.001). Significant indirect associations were also observed via perceived parenting style (β = 0.06, 95% CI [0.03, 0.11]) and childhood traumatic experiences (β = 0.07, 95% CI [0.04, 0.12]). Childhood trauma accounted for a larger proportion of the indirect association, while parenting style contributed a smaller but significant pathway. When both pathways were included simultaneously, the direct association between PSMU and AN symptoms remained significant, indicating partial mediation. Model fit indices indicated good overall fit. Conclusions: Problematic social media use is meaningfully associated with anorexia nervosa symptoms among adolescent girls, both directly and through indirect pathways involving parenting context and childhood trauma. Childhood trauma may be interpreted as a variable showing a significant indirect statistical association with both problematic social media use and anorexia nervosa symptoms, rather than a causal determinant within the present design. These findings underscore the importance of integrated, trauma-informed and family-sensitive prevention strategies that address adolescents’ digital environments alongside broader psychosocial vulnerabilities. Full article

Background/Objectives: Diet is an essential factor influencing health and the preventive management of some diseases. There is little research to date on the diet of organic food producers, particularly organic ones. The present study aimed to investigate the diet quality of organic and conventional fruit growers. Methods: Fifty-three fruit growers, including 28 organic and 25 conventional, took part in the study. Body weight and height were measured. Body composition was estimated using the BIA method. Information on dietary intake was collected using a 3-day dietary record. Diet quality scores were calculated using the Healthy Eating Index-2015 (HEI-2015) and the Diet Quality Index International (DQI-I). Results: The diet quality of the orchardists was low (31.7 ± 9.3 points on the HEI scale and 54.3 ± 7.5 points on the DQI-I scale). Organic fruit growers scored significantly higher on both scales, compared to conventional fruit growers (p < 0.001 and p = 0.002 for HEI and DQI-I, respectively) and had a lower percentage of BF and a higher percentage of FFM and TBW in their bodies (p = 0.013, p = 0.049 and p = 0.049, respectively). Consumers of organic products had better diet quality scores, and diet quality increased as the percentage of organic food consumption increased. Both diet quality and the percentage of organic food consumed were associated with participants’ self-assessed nutritional knowledge. Conclusions: Diet quality was associated with the type of agricultural practice and with organic food consumption. As a pilot cross-sectional study based partly on self-reported measures, the observed differences should be interpreted cautiously. They may also partly reflect broader lifestyle-related factors. Further research on similar groups is needed to confirm these relationships, preferably with an assessment of respondents’ nutritional knowledge. Full article

Background and hypothesis: Sodium–glucose cotransporter 2 inhibitors (SGLT2i) provide consistent cardiorenal benefits; however, tissue-level mechanisms remain insufficiently characterized. We investigated whether SGLT2i were associated with longitudinal remodeling of organ-specific adipose depots in patients with chronic kidney disease (CKD). Methods: In this observational study cohort (ADIPO-CKD; NCT07309094), adults with CKD stages 1–4 underwent clinical, biochemical and ultrasound imaging assessment at baseline (T0) and 8-month follow-up (T8). Thus, epicardial (EAT) and perirenal adipose tissue (PRAT) thickness were measured. Changes over time between patients under SGLT2i treatment and those without (Non-SGLT2i) were assessed using repeated-measures ANOVA and multivariable linear regression models adjusted for age, sex, baseline estimated glomerular filtration rate (eGFR), diabetes status, concomitant glucagon-like peptide 1 (GLP-1) receptor agonist therapy, body mass index (BMI) and visceral fat area (VFA) changes. Results: Among 189 CKD patients (50 SGLT2i and 139 non-SGLT2i), SGLT2i therapy was associated with significant reductions in PRAT (1.28 ± 0.70 to 0.91 ± 0.61 cm; ΔPRAT −0.37 cm; p < 0.002) and EAT (0.57 ± 0.27 to 0.36 ± 0.14 cm; ΔEAT −0.21 cm; p < 0.012), whereas no significant changes were observed in the Non-SGLT2i group. In multivariable models, SGLT2i exposure remained independently associated with ΔPRAT (β = 0.447; 95% CI 0.211–0.682; p < 0.001; R² = 0.371) and ΔEAT (β = 0.061; 95% CI 0.009–0.113; p < 0.021; R² = 0.053), including adjustment for changes in BMI and VFA. These findings were accompanied by trends toward improvement in renal function and systemic inflammation biomarkers in the SGLT2i group, although these changes did not reach statistical significance. In a secondary analysis, dapagliflozin was significantly associated with PRAT reduction, whereas a significant association was found between empagliflozin and EAT decrease. Conclusions: In CKD stages 1–4, SGLT2i use was independently associated with reductions in EAT and PRAT. These findings support a potential link between organ-specific adipose tissue and cardiorenal disease; however, given the observational design, these results should be interpreted as associative and hypothesis-generating. Dedicated mechanistic and adequately powered studies are warranted to determine their clinical relevance. Full article

Objectives: This cross-sectional study examined associations of lifestyle factors (physical activity (PA), diet, obesity, and smoking), age groups, and sex with the prevalence of non-communicable diseases (NCDs) in Saudi adults, including the World Health Organization (WHO) core NCDs (type 2 diabetes (T2DM), hypertension (HTN), chronic obstructive pulmonary disease (COPD) and NCD-associated conditions (osteoporosis (OP), chronic kidney disease (CKD)). Methods: A cross-sectional study was conducted across Saudi Arabia involving 2877 participants aged ≥30 years. Data were collected via an electronic survey using a standardized questionnaire. PA was assessed using the International PA Questionnaire (IPAQ-SF), diet using the Alternative Healthy Eating Index (AHEI), and smoking using the WHO Global Adult Tobacco Survey. Results: Prevalence estimates were: OP 22%, diabetes 21.8%, HTN 13.4%, COPD 4.3%, and CKD 5.1%. All conditions were more prevalent among inactive vs. active individuals (e.g., diabetes: 23.5% vs. 18.8%). An unhealthy diet was associated with higher prevalence (e.g., HTN: 16.3% vs. 10.8%). Obesity showed the strongest association with diabetes (37.1% in obese vs. 14.9% in normal-weight). Smoking was associated with higher prevalence (e.g., COPD: 7.9% vs. 3.7%). Women had higher prevalence than men for most conditions (e.g., OP: 23.4% vs. 19.7%), except COPD (5.1% in men vs. 3.8% in women). Prevalence increased with age (e.g., HTN: 7.2% at age 30–40 vs. 17.3% at age > 60). All comparisons were tested using chi-square tests (p < 0.05). Conclusions: The findings underscore an urgent need for targeted public health interventions to promote PA, improve nutrition, combat obesity, and reduce smoking. Full article

Background and aims: The aim of this study was to examine the relationships between muscle function, dietary quality, body composition markers, and metabolic status in ambulatory patients with type 2 diabetes. The study sought to validate low-cost tools, such as handgrip strength and waist circumference, as potential “nursing vital signs” for metabolic risk stratification. Methods: A cross-sectional observational study was conducted with adult patients with type 2 diabetes. Muscle function was assessed through handgrip strength (dynamometry) and metabolic status via the HOMA-IR index. Visceral adiposity was estimated using waist circumference and the Lipid Accumulation Product (LAP); dietary quality was evaluated with the Spanish Healthy Eating Index (IASE), and cellular health through the phase angle (PhA) obtained by electrical bioimpedance. Non-parametric tests and Spearman correlations were applied due to the non-normal distribution of the data. Conclusions: In this ambulatory diabetic population, waist circumference emerged as a practical and potent surrogate for insulin resistance burden. Although metabolic dysfunction was not directly associated with dietary quality or phase angle, a high prevalence of probable sarcopenia (36.1%) and poor dietary quality (77.8%) were detected. The implementation of non-invasive tools like waist circumference and handgrip strength in nursing consultations could optimize early risk stratification and allow for more targeted lifestyle interventions. Full article

Chrononutrition, which emphasizes the timing, frequency, and regularity of eating in alignment with circadian rhythms, has emerged as an important yet understudied determinant of obesity, particularly in children and adolescents. We aimed to compare chrononutrition and physical fitness between elementary and intermediate schoolgirls and to examine their associations with obesity. Methods: This cross-sectional study included 457 schoolgirls aged 10–14 years from elementary and intermediate schools. Chrononutrition behaviors were evaluated. Anthropometric measurements and physical fitness, including handgrip strength, standing long jump, and 20 m shuttle run, were assessed. Fasting blood glucose and lipid profile were determined using capillary blood samples. Results: Compared with intermediate students, elementary school students demonstrated more favorable meal-related behaviors, longer overnight fasting durations, and better dietary intake (p < 0.05), along with higher VO₂ max and higher standing long jump performance. Conversely, intermediate students exhibited greater absolute handgrip strength. A higher number of meals/day (aOR = 0.68, p = 0.039) and a longer interval between the last meal and bedtime (aOR = 0.78, p = 0.013) were inversely associated with obesity. Furthermore, higher HGS/BMI was associated with lower odds of obesity (aOR = 0.01, p < 0.001), while HDL cholesterol was inversely associated with obesity (aOR = 0.91, p < 0.001). Conclusions: Chrononutrition behaviors and physical fitness varied across school stages and were associated with obesity among school-aged girls. Higher meal frequency, a longer interval between the last meal and bedtime, and greater handgrip strength relative to body mass index (HGS/BMI) were associated with lower odds of obesity. Non-obese students also demonstrated higher VO₂ max. These findings suggest that chrononutrition behaviors and physical fitness may contribute to obesity prevention, underscoring the importance of early nutrition and physical activity interventions. Full article

To clarify the genetic background and biological characteristics of grape germplasm resources and provide theoretical support for germplasm innovation and new-variety breeding, we conducted systematic morphological identification and SSR molecular-marker analysis on 38 core grape germplasms (29 fresh-eating cultivars, 1 local cultivar, and 8 wild germplasms) from the National Southeast Mountainous Crop Germplasm Repository (Jiangxi·Yichun) and other regions. For morphological identification, 14 quantitative traits and 5 descriptive traits of leaves, floral organs and fruits were determined in strict accordance with the NY/T 2932-2016 Descriptors for Grape Germplasm Resources. For SSR molecular-marker analysis, eight pairs of internationally universal core primers were used for PCR amplification and fluorescence detection referring to the NY/T 3640-2020 Identification of Grape Cultivars Using SSR Markers, and genetic diversity analysis was conducted on 11 local and wild grape germplasms. The results revealed abundant phenotypic diversity among the tested germplasms: the functional leaves of cultivars were predominantly pentagonal and cuneate, while those of wild germplasms were mostly reniform and cordate, with 3–5 lobes for most germplasms; all germplasms were hermaphroditic, except for two wild accessions with unisexual flowers. Significant variations were observed in fruit traits, with the coefficient of variation (CV) of cluster weight and berry weight reaching 67.64% and 50.53%, respectively. The genetic plasticity of weight-related traits was much higher than that of shape- and length-related traits, and the average Shannon–Wiener index (H′) of 19 morphological traits was 3.47, indicating a high level of overall phenotypic diversity. SSR analysis showed that the eight primer pairs amplified a total of 42 genotypes (5.25 per primer pair on average). The population had a mean observed number of alleles (Na) of 5.28, a mean effective number of alleles (Ne) of 7.25, and a mean polymorphism information content (PIC) of 0.74, demonstrating rich genetic diversity and high polymorphism of the tested loci. Cluster analysis divided the 11 local germplasms into four groups, which clearly reflected the genetic relationships among them, and genetic admixture was found in some germplasms due to unclear introduction traceability. In this study, fresh-eating grape cultivars suitable for the climatic conditions of Jiangxi Province were screened, the utilization value of local germplasm resources was clarified, and a two-dimensional evaluation system based on phenotypic traits and SSR molecular markers was constructed. The findings provide basic data and a scientific basis for the precise evaluation, elite gene mining, and new-variety breeding of grape germplasm resources in Jiangxi Province. Full article

Background/Objectives: Unhealthy dietary behaviors and suboptimal oral hygiene practices remain common among Italian children, potentially affecting both nutritional and oral health. Dental caries, a preventable yet highly prevalent condition in pediatric populations, has a multifactorial etiology in which lifestyle factors play a key role. This study aimed to assess the prevalence of dental caries, dietary habits, and oral hygiene behaviors in school-aged children in Lombardy, and to identify factors associated with prevalent caries status. Methods: A cross-sectional study was conducted on 307 schoolchildren aged 9–10 years from ten schools in Northern Italy. Oral health status was evaluated through the plaque index and the DMFT/dmft index during school-based dental examinations. Dietary habits, lifestyle, and oral hygiene practices were collected through structured questionnaires. A mixed-effects logistic regression model was developed to explore potential associations between variables and prevalent caries status. Results: The dietary patterns, weight status, oral hygiene behaviors, and oral health conditions were generally consistent with the national data. Higher plaque index, skipping breakfast, consuming mid-morning snacks, and parental reports of previous caries experiences were retained in the final model. Internal validation suggested reasonable discriminatory ability overall, whereas calibration shows heterogeneity across schools. Conclusions: The findings highlight suboptimal dietary and oral hygiene behaviors among Lombardy schoolchildren and confirm their association with dental caries. Lifestyle-related factors, particularly oral hygiene practices and eating patterns, showed a relevant association with prevalent caries status in the analyzed sample. These results underscore the need for targeted preventive strategies integrating nutritional education and oral health promotion in pediatric populations. Full article