Search Results (896)

Background and Objectives: Sarcopenic obesity, or the coexistence of sarcopenia and obesity, carries an additional load of health risks, including functional decline and metabolic disorders. Despite its increasing importance, data on Korean adults’ prevalence and risk factors are poor. The objective of this study was to estimate the prevalence of sarcopenic obesity, sarcopenia, and obesity to identify factors associated with each condition using the most recent nationally representative data. Materials and Methods: This study analyzed data from 4332 adults aged ≥ 40 years who participated in the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Sarcopenia was defined using the appendicular skeletal muscle index (SMI) via bioelectrical impedance analysis (BIA), and obesity by waist circumference per Korean criteria. Participants were categorized into four body composition groups. Complex sample logistic regression was used to identify factors independently associated with each condition. Results: The prevalence rates of sarcopenic obesity, sarcopenia-only, and obesity-only were 1.9%, 14.4%, and 35.5%, respectively. Sarcopenic obesity was significantly more common among older women with low education level, poor subjective health, diabetes, and low HDL-C. They were associated with older age, lower physical activity, lower education level, past smoking, and poor health condition. Obesity was associated with male sex, diabetes, hypertension, dyslipidemia, and moderate-to-poor perceived health. Conclusions: Sarcopenic obesity, while less prevalent, is relatively uncommon and represents a high-risk phenotype associated with metabolic and functional deficits. These results highlight the importance of identifying vulnerable subgroups and implementing targeted strategies that address both muscle loss and adiposity in aging Korean adults. Full article

Background/Objectives: Obesity in adolescence is associated with a deterioration in cognitive functions, with significant implications for psychophysical well-being and academic performance. Recent studies highlight the importance of integrated interventions that combine nutrition education and physical activity to promote the overall health of students. The present study aims to evaluate the efficacy of an integrated intervention based on nutritional education and conscious body movement in improving cognitive functions, perceived well-being and nutritional knowledge in lower secondary school students with indicators of overweight and obesity. Methods: A quasi-experimental design with randomization at the class level was adopted, involving 60 students divided into an experimental group and control group. The intervention was divided into twelve weeks of activities, divided between nutritional education modules and physical activity courses. Standardized tests for the assessment of cognitive functions (Digit Span Forward, Digit Span Backward, Stroop Test, Trail Making Test B), motor tests (6-Minute Walk Test, Sit and Reach Test) and a food knowledge questionnaire were administered before and after the intervention. Results: The experimental group showed significant improvements compared to the control group in all cognitive, motor, and nutritional knowledge measures, indicating the effectiveness of the integrated intervention in promoting cognitive and physical well-being. Conclusions: The findings support the role of school as a generative environment of integrated well-being, suggesting the need to develop and implement curricular programs that integrate nutrition education and physical activity to counteract the negative effects of obesity on cognitive function in adolescents. Full article

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

Background and Objectives: Handgrip strength represents a critical indicator of physical fitness and nutritional status in adolescents, yet population-specific reference values remain limited in developing countries. Understanding age- and sex-specific variations is crucial for accurate clinical assessment and effective health monitoring. The objective of this study was to establish comprehensive reference values for handgrip strength in healthy Tunisian adolescents aged 13–19 years and examine sex and age group differences in these measures. Materials and Methods: This cross-sectional study was conducted between September 2024 and June 2025, involving a sample of 950 participants (482 males, 468 females) aged 13–19 years from northwest Tunisia. Handgrip strength was measured using standardized dynamometry protocols for both hands. Anthropometric measurements included height, weight, and body mass index. Percentile curves were generated using the LMS method, and correlations between handgrip strength and anthropometric variables were analyzed using Pearson correlation coefficients. Results: Males demonstrated significantly higher handgrip strength than females from age 13 onward (13 years: p = 0.021; 14–19 years: p ≤ 0.001). Effect sizes for sex differences were consistently large across age groups (Cohen’s d range: 0.53–2.09 for the dominant hand). Mean dominant handgrip strength ranged from 25.60 ± 7.73 kg to 47.60 ± 12.45 kg in males and 21.90 ± 6.13 kg to 28.40 ± 4.74 kg in females across age groups. After adjusting for body mass, sex differences remained significant between groups (13 years: p = 0.014; d= 1.5; 14–19 years: p ≤ 0.001; d: 1.71–3.12). Strong positive correlations emerged between handgrip strength and height (males: r = 0.748, females: r = 0.601), body mass (males: r = 0.659, females: r = 0.601), and body mass index (BMI) (males: r = 0.391, females: r = 0.461). Body mass and height emerged as the strongest predictors of handgrip strength in both sexes, while BMI showed a smaller but still significant contribution. Conclusions: This study provides the first comprehensive age- and sex-specific reference values for handgrip strength in Tunisian adolescents. Healthcare providers can utilize these percentile charts for the clinical assessment and identification of musculoskeletal fitness deficits. The results suggest its use in educational and clinical contexts. Full article

Background/Objectives: Childhood/youth are ideally the best periods to teach healthy behaviors; unfortunately, children/adolescents are frequently characterized by unhealthy lifestyles and reduced well-being. Lifestyle improvement early in life may play a fundamental role in determining present health, preventing many chronic diseases, and fostering well-being. Having a clear picture of the lifestyle characteristics of a group can help institutions and schools define effective educational and intervention strategies. This observational study aims to examine whether information collected from children and adolescents about their lifestyles and perceptions of well-being could help identify particular groups that deserve specific interventions, implemented by the school, to improve their overall health. Methods: After administering a simple lifestyle/well-being questionnaire to 225 children/adolescents at an Italian school complex, we investigated the relationships between lifestyles and perceptions of well-being by constructing statistical indicators through nonlinear principal component analysis. Then, we defined lifestyle typologies based on lifestyle indicators and studied the distribution of the well-being indicator across such typologies, also adjusting for sex and age effects. Results: The study shows that lifestyle worsens with age (p < 0.001) and influences overall well-being perception. We identified four lifestyle typologies by combining two indicators of sedentary behavior and sleep, and of quality of nutrition and the volume of physical activity. The healthier the lifestyle, the better the overall well-being perception is (represented by the indicator that includes the perceived quality of health, sleep, and academic performance) (p = 0.005). Conclusions: Tailored educational/intervention strategies that consider specific groups’ characteristics, rather than general counseling, might be more effective at improving health/well-being. Full article

Background/Objectives: Breast milk donation is increasingly recognized as a vital public health resource, providing optimal nutrition for infants who cannot be breastfed by their biological mothers. Human milk banks play a crucial role in supporting infant health, particularly for preterm and medically vulnerable infants. Despite its recognized benefits, the practice of breast milk donation and utilization remains influenced by a complex interplay of individual, social, and cultural factors. Methods: This study systematically examines how demographic and sociocultural variables are associated with attitudes and behaviors related to breast milk donation. Data were collected from 1223 Israeli mothers via questionnaires distributed through WhatsApp groups between April and May 2025. By analyzing the questionnaire results, the research identified key predictors of willingness to donate and use donated milk, as well as patterns of awareness and perceived support within different population groups. Results: Higher education (χ² = 12.87, p = 0.0016) and settlement type (χ² = 83.096, p = 0.000) were significantly associated with greater willingness to donate breast milk. Income level had no effect on donation behavior, though higher-income participants were more open to its use (χ² = 86.838, p = 0.000). Lifestyle also influenced perceptions of social support (F(2, 1220) = 259.4036, p < 0.001) and cultural support (F(2, 1220) = 601.2383, p < 0.001) of milk donation and use. Significant correlation was found between perceived cultural and social support (t = 5.140, p = 0.000), emphasizing their interrelated influence on milk donation attitudes. Conclusions: The findings assist in guiding the development of public health policies, as well as targeted awareness campaigns, to promote equitable access to donor milk services across varied communities. From the public health perspective, the findings of this study can orientate campaigns that encourage both donation and use of breast milk focusing on segments of the population in which the level of awareness is relatively low. Full article

Health education programs are important interventions aimed at the acquisition of health knowledge and behaviors that are necessary throughout the lives of individuals of all ages. Considering the importance of health education in structuring the health of the society, it is very important that health education responds to the needs of society and meets its expectations. At this point, public health is protected by providing access to families and communities through health education. In this context, a needs analysis study was conducted with families (students and parents) to establish a health education framework. The study group consisted of 289 volunteer primary and secondary school students and 60 parents who agreed to participate in the study. Semi-structured interviews were conducted with students and parents using a descriptive approach. The needs analysis form prepared by the researchers was used in the interviews and content analysis was applied to the obtained data. The qualitative data obtained from the analyses were interpreted. As a result of the study, it was found that families have expectations and needs in first aid and daily life behaviors (nutrition, hygiene, oral health and diseases) in school health education, and accordingly, school health education can be focused on these specified areas. The fact that families found health knowledge insufficient and considered health education important emphasizes the importance of the knowledge provided by health education and the results. The family health education views obtained in the study can be used in future studies to improve family health behaviors and community health. In addition, family-based school health education can be disseminated with contemporary interventions. Full article

Background: Chinese school-age students are at a high risk of developing obesity. However, few studies have reported individualized ways to prevent obesity by age, gender, and living regions. Methods: A total of 11,285 students aged 6–18 years were recruited and participated in this cross-sectional study. Questionnaires were used to assess scores of dietary diversity (DDS), physical activity (PA) duration, and nutritional literacy awareness. According to age and gender-specific BMI thresholds, the participants were categorized into normal and participants with obesity groups. Pearson correlation and logistic regression analysis were used to explore the association between nutritional literacy, DDS, PA, and the risk of BMI or obesity. Results: Scores of nutritional literacy were positively associated with Total DDS, Plant DDS, Animal DDS, and PA, and were negatively associated with BMI. High Total DDS (OR = 0.878, p = 0.030), Plant DDS (OR = 0.885, p = 0.027), and PA (OR = 0.869, p = 0.022) were strongly associated with a low risk of obesity. Furthermore, high Total DDS and Plant DDS decreased the risk of obesity only in the high PA group but not in the low PA group. High PA only decreased the risk of obesity in the high Total DDS and high Plant DDS group. Gender-, age-, and living-region-specific associations were also observed. Conclusions: Diverse dietary intakes and physical activity are essential for reducing the risk of obesity in Chinese school-age students. Notably, gender-, age-, and living-region-specific health and nutritional literacy education are required in school-age children to prevent obesity. Full article

South Africa’s bioeconomy strategy identifies bio-innovation as a key driver of economic growth and social development, with plant breeding playing a central role in improving food security through the development of high-yielding, resilient, and high-quality crops. However, consumer perceptions of recent advances, particularly new breeding techniques (NBTs), remain underexplored. This study examines South African consumer attitudes towards plant breeding innovations, using a mixed-methods approach. The initial focus group interviews informed the development of a structured quantitative survey examining familiarity, perceptions, and acceptance of plant breeding technologies. Consumer awareness of plant breeding principles was found to be limited, with 67–68% of respondents unfamiliar with both conventional and modern plant breeding procedures. Despite this information gap, consumers expressed conditional support for modern breeding techniques, especially when associated with actual benefits like increased nutritional value, environmental sustainability, and crop resilience. When favourable effects were outlined, support for general investment in modern breeding practices climbed from 45% to 74%. Consumer purchase decisions emphasised price, product quality, and convenience over manufacturing techniques, with sustainability ranked last among the assessed factors. Trust in the sources of food safety information varied greatly, with medical experts and scientists being ranked highly, while government sources were viewed more sceptically. The results further suggest that targeted education could improve customer confidence, as there is a significant positive association (R² = 0.938) between familiarity and acceptance. These findings emphasise the significance of open communication strategies and focused consumer education in increasing the adoption of plant breeding breakthroughs. The study offers useful insights for policymakers, researchers, and industry stakeholders working on engagement strategies to facilitate the ethical growth and application of agricultural biotechnology in support of food security and quality in South Africa. This study contributes to a better understanding of South African consumers’ perceptions of plant breeding innovations and food safety. The research findings offer valuable insights for policymakers, researchers, and industry stakeholders in developing effective engagement and communication strategies that address consumer concerns and promote the adoption of products derived from diverse plant breeding technologies. Full article

Background: Frailty is common in colorectal cancer (CRC) patients and is associated with poor prognosis and increased mortality. Anti-inflammatory dietary education is a promising and cost-effective strategy for frailty improvement. Methods: A prospective, assessor-blinded, two-arm randomized controlled trial was conducted to assess the effects of a 12-week dietary inflammatory index (DII)-based anti-inflammatory dietary education program on frailty in frail CRC patients. Participants in the intervention group received a DII-based anti-inflammatory dietary education, while the control group received a routine health education. Outcome measurements included the Fried frailty phenotype (FP), DII, plasma inflammatory biomarkers, body mass index (BMI), nutritional status, and quality of life (QoL), which were all assessed at baseline and post-intervention. Results: A total of 86.4% (57/66) of participants completed the follow-up. No statistically significant baseline differences were observed between groups. After the intervention, the intervention group showed significant improvements in DII (p = 0.029), BMI (p = 0.012), mini nutritional assessment (MNA) scores (p = 0.027), and QoL (p = 0.014) compared with the control group. Within-group comparisons revealed significant decreases in frailty status (p = 0.031), DII (p = 0.008), and interleukin (IL)-6 (p = 0.003), and significant increases in IL-10 (p = 0.021), MNA scores (p = 0.010), and QoL (p < 0.001) in the intervention group, with no significant changes in the control group. Conclusions: DII-based anti-inflammatory dietary education can improve the frailty, nutritional status, and QoL of frail CRC patients by modulating systemic inflammation. Given its acceptability and utility, this strategy may be incorporated into routine cancer health education. Full article

Access to high-quality, culturally responsive nutrition advice during pregnancy is necessary for optimal health outcomes for mothers and babies. Evidence indicates that age, education and access to trained healthcare practitioners have a positive correlation with healthy food intake and positive outcomes. There are limited studies that discuss the importance of providing culturally responsive nutrition advice to pregnant Indigenous women. Therefore, this paper investigates the sources from which Indigenous women access nutrition information, assesses its adequacy in meeting needs, and identifies the effective ways to deliver this information. This study took place in Queensland (QLD), New South Wales (NSW), and Western Australia (WA), which were chosen to represent diverse cultural communities. A total of 103 participants were recruited, including Indigenous women and healthcare practitioners. Focus groups were audio-recorded, transcribed and analysed. Participants indicated that pregnant women are highly interested in improving their nutrition knowledge during pregnancy and actively seek information from their healthcare practitioners and dietitians. Findings suggested dissatisfaction with the information received, as it failed to address their needs. Results of this paper call for an urgent increased presence of community dietitians in antenatal clinics dedicated to Indigenous pregnant women as an additional way to provide families with the information they need for healthy pregnancies. Full article

Butterflies (Lepidoptera: Papilionoidea), considered bioindicators of habitat conservation status, are one of the groups used to assess the impact of habitat management and improvement efforts in the Biological Station of Torretes (Ibi, Alicante, Spain). This area also houses the Botanical Garden of the University of Alicante. The study was focused on the period from autumn 2022 to late spring 2023, and data on butterfly diversity and abundance from the current study were compared with historical data. Our results highlight that open spaces and the availability of trophic resources (nutritional plants) were key factors influencing the richness and abundance of Papilionoidea. The program for the creation and maintenance of new habitats at the biological station has increased spatial heterogeneity and the availability of trophic resources, which has led to a significant increase in the richness and abundance of butterflies in a short period. To support the conservation of Mediterranean ecosystems, and entomofauna in general, the Papilionidae are proposed as model groups for designing conservation projects based on traditional habitat management. These projects should promote spatial heterogeneity, include programs to enrich plant diversity, and be complemented by environmental education and outreach initiatives. Full article

Background: Dyslipidemia affects over 30% of Chinese adults, with awareness rates below 20%. Promoting nutrition education programs in the general population is important, but few studies have investigated the specific strategies and their efficacy. Methods: This longitudinal study was conducted in a representative sample of community-dwelling adults in Lu’an City, central-eastern China. After recruitment and propensity score matching, the personalized and conventional nutrition education groups included 306 and 612 participants, respectively. We provided standardized nutrition education based on the Dietary Guidelines for Chinese Residents (2022) for the conventional group, and personalized nutrition advice based on individual food intake and the guidelines for the personalized group. Serum total cholesterol (TC), high-density lipo-protein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs) were measured at baseline and again after follow-up. Results: Three years after the intervention, the average levels of TC, LDL-C, and TG in both groups all increased. After adjusting for covariates, an increase in HDL-C was greater in the personalized group than in the convention group, while the increment in TG was less pronounced. LDL-C changes were similar between the groups. The beneficial effect of personalized nutrition education on HDL-C levels was more pronounced in women (p_interaction < 0.05). Similar results were observed among participants with dyslipidemias and after excluding all lipid-lowering medication users. Conclusions: We conducted personalized nutrition education through medical students’ community practice projects among Chinese community residents, revealing that personalized nutrition education based on dietary surveys could significantly improve blood lipid profiles in general residents and individuals with dyslipidemias compared to conventional nutrition education. Full article

Nutrition education, framed within Supplemental Nutrition Assistance Program Education (SNAP-Ed) guidance, was provided to SNAP-eligible shoppers at community supported agriculture (CSA) sites in Michigan where SNAP nutrition incentives were accepted. An evaluation was conducted on data sources from sites where the CSA Food Navigator program was implemented to assess the delivery of nutrition education, understand the needs and experiences of SNAP-eligible shoppers, and measure behavioral outcomes. A multi-phase, mixed-methods design incorporated (1) outcome surveys with SNAP-eligible shoppers at participating CSA sites; (2) open-ended feedback surveys from CSA site staff; (3) nutrition educator activity logs; (4) a semi-structured nutrition educator focus group; and (5) semi-structured focus groups with SNAP-eligible shoppers. In phase one, descriptive analysis was completed on the quantitative data and constant comparative analysis was completed on the qualitative data. In phase two, these data were collated into case reports for respective CSA sites; then, a cross-case analysis was performed. In phase three, statistical tests were performed on SNAP-eligible shoppers’ survey data to assess outcomes against a nationally representative sample of nutrition incentive program participants. Results indicate significantly higher fruit and vegetable consumption among shoppers relative to SNAP incentive participants nationally. Key qualitative themes were (1) relating over transacting: investing in multi-level relationships, (2) personalizing engagement and experiential nutrition education, (3) activating social–ecological spheres to promote changes in access, and (4) enhancing education support and resources for accessibility. The findings have practical implications to enhance the delivery and impact of CSA-based nutrition education. Full article

Nutritional risk factors are country-specific and change over time, requiring systematic verification. Objective: The study was designed to develop a nutritional risk factors model for seniors living in a Polish community. Methods: The pilot study was conducted in 2022 and 2023 among 301 people aged 60 and older in the Lower Silesia region of Poland. The questionnaire contained 107 test items describing dietary problems rated on a five-point Likert scale. The pre-study concerned understanding of the test items, rating the reproducibility (kappa statistic) and reliability of the scale (α-Cronbach coefficient). The factor structure of the model was developed using structural equation modelling (SEM) in the program R (version 4.3.2.). An exploratory factor analysis (EFA) extracted the three-factor model. Results: The factors were described as unhealthy eating (eight test items), irregularities related to meals (four test items), and perception of body weight (four test items). The model was verified using confirmatory factor analysis (CFA). The model’s acceptability was confirmed based on data matching indexes, convergent accuracy, differential accuracy, and measurement reliability. There was variation in the identified nutritional risk factors by gender, education, social activity, and family relationships. Conclusions: Focusing on irregularities in nutrition and perception of body weight as nutritional risk factors reveals a very narrow perspective in diagnosing nutritional risk, thus further testing of the model, in a representative group of older people in Poland and other countries, is necessary to confirm the results obtained. Full article