Search Results (769)

Background: Eating disorders (EDs) are important mental illnesses that are often associated with depression and anxiety, leading to significant negative consequences. However, research on this topic in Saudi Arabia remains limited. This study aims to examine the risk of EDs among male and female medical students at King Saud University (KSU) and assess their risk factors and association with anxiety and depression. Methods: A cross-sectional study involving 425 participants was conducted, using a convenience sampling method. The study tools consisted of a questionnaire developed by the research team, the Eating Attitudes Test-26 (EAT-26), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 scale (GAD-7). Results: Almost half (49.6%) were classified as high risk for EDs. Obesity was much higher among high-risk students than low-risk students (p < 0.001). Anxiety and depression were greater among high-risk students than low-risk ones. A higher body mass index (BMI) and depression greatly increased the risk of EDs (p < 0.001). Conclusions: The findings support the notion that medical students have a significant likelihood of developing EDs, especially if they have a high BMI and are depressed. The results show the importance of early identification and offering appropriate interventions to this vulnerable group. Full article

This study aimed to test the factorial structure of the Eating Motivation Survey (TEMS) using Confirmatory Factor Analysis (CFA) in a sample of 632 university students from the Western Brazilian Amazon. A cross-sectional study was conducted between December 2022 and April 2023 with participants of both sexes, aged 18 or older. In addition to CFA, psychometric analyses were performed, and a Structural Equation Model was developed to examine the relationships between individual characteristics (age, sex, and Body Mass Index (BMI)) and the TEMS constructs. The results showed that 58.3% of participants were female, with a mean age of 25.29 years. The CFA supported an eight-factor model (health, natural concerns, socialization, price, visual appeal, weight control, emotional control, and social image) with 24 items, presenting good validity and reliability indices. Older individuals and those with lower BMIs prioritized health, natural concerns, and weight control, while younger participants, women, and those with higher BMIs were more influenced by emotional control. The findings contribute to understanding eating motivations in culturally diverse contexts and may support strategies aimed at promoting healthier dietary behaviors and preventing diet-related chronic diseases. Full article

Background: Eating disorders are increasingly diagnosed in young women, particularly during adolescence. The recently described Anorexic Readiness Syndrome (ARS) is more common than full-blown anorexia. It has been identified in female athletes engaging in disciplines focusing on the aesthetics of the body, in women involved in recreational exercise and in those who are not physically active but strive to achieve the “perfect” figure. The study aimed to assess the severity and prevalence of ARS in women regularly engaging in body-shaping physical activity. Methods: The study included 659 women aged ≥ 14 years who engaged in regular body-shaping physical activity, provided informed consent to participate in the study (in the case of minors, also the consent of a parent or legal guardian), and had no diagnosed chronic diseases. The level of ARS was assessed using a questionnaire measuring attitudes toward food, supplemented with a specially designed survey consisting of 32 questions and a personal data form. Based on the frequency of body-shaping physical activity, participants were divided into two groups: the study group comprised women exercising ≥ 3 times per week (n = 301), while women exercising < 3 times per week constituted the control group (n = 358). The analyses examined the relationships between ARS, frequency of body-shaping physical activity, BMI, and menstrual irregularities. Results: Medium or high ARS level was identified in over 96% (n = 637) of the respondents. The level of ARS was significantly related to the allocation into the group (p = 0.034) and the weekly hours of physical activity (p = 0.011 in the control group; p = 0.020 in the study group). There was a correlation between ARS and menstrual irregularities (p = 0.001). Weak but significant correlations were identified for awareness of eating disorders (V = 0.20; p = 0.001), adherence to a special diet (V = 0.18; p < 0.001) and self-assessed health (V = 0.18; p < 0.001). Conclusions: Higher ARS levels were observed in women reporting greater weekly physical activity. No significant associations were found between ARS and body mass index or body weight. Medium and high ARS levels were significantly associated with self-reported menstrual disturbances, while most participants with elevated ARS were unaware of disordered eating risk. Full article

Background/Objectives: Chrononutrition—the temporal organization of food intake relative to circadian rhythms—has emerged as an important factor in cardiometabolic health. While meal timing is typically analyzed as an isolated variable, limited research has examined integrated meal timing patterns, and no study has systematically compared clustering approaches for their identification. This cross-sectional study compared four clustering techniques—traditional (K-means, Hierarchical) and non-traditional (Gaussian Mixture Models (GMM), Spectral)—to identify meal timing patterns from habitual breakfast, lunch, and dinner times. Methods: The sample included 388 Mexican university students (72.8% female). Patterns were characterized using sociodemographic, anthropometric, food intake quality, and chronotype data. Clustering method concordance was assessed via Adjusted Rand Index (ARI). Results: We identified five patterns (Early, Early–Intermediate, Late–Intermediate, Late, and Late with early breakfast). No differences were observed in BMI, waist circumference, or age among clusters. Chronotype aligned with patterns (morning types overrepresented in early clusters). Food intake quality differed significantly, with more early eaters showing healthy intake than late eaters. Concordance across clustering methods was moderate (mean ARI = 0.376), with the highest agreement between the traditional and non-traditional techniques (Hierarchical–Spectral = 0.485 and K-means-GMM = 0.408). Conclusions: These findings suggest that, while traditional and non-traditional clustering techniques did not identify identical patterns, they identified similar core structures, supporting complementary pattern detection across algorithmic families. These results highlight the importance of comparing multiple methods and transparently reporting clustering approaches in chrononutrition research. Future studies should generate meal timing patterns in university students from other contexts and investigate whether these patterns are associated with eating patterns and cardiometabolic outcomes. Full article

Background/Objectives: The Mediterranean diet (MD) constitutes one of the most broadly studied dietary patterns, which has been linked to the prevention of non-communicable diseases and mental health disorders. University students, a population exposed to significant psychosocial stressors and lifestyle changes, may particularly benefit from healthy eating patterns such as the MD. This study was designed to examine the potential associations of MD adherence with symptoms of depression and anxiety among Greek university students. Methods: A cross-sectional study was initially conducted among 7160 active university students from ten diverse geographic regions in Greece. After the enrollment procedure and the application of relevant exclusion criteria, 5191 university students (52.0% female; mean age: 21.3 ± 2.4 years) constituted the study population. MD adherence was assessed using the KIDMED index, while depressive and anxiety symptoms were evaluated using the Beck Depression Inventory-II (BDI-II) and State–Trait Anxiety Inventory (STAI-6), respectively. Sociodemographic and anthropometric data were collected for all the enrolled university students. All the questionnaires were completed by face-to-face interviews with expert personnel. Results: Students with low adherence to the MD were significantly more likely to report symptoms of depression (OR = 2.12; p ˂ 0.001) and anxiety (OR = 2.27; p ˂ 0.001) and to be overweight or obese (OR = 2.45; p ˂ 0.001) after adjustment for multiple confounding factors. Low MD adherence was also associated with male gender (OR = 0.73; p ˂ 0.01), living alone (OR = 0.78; p ˂ 0.01), smoking (OR = 0.75; p ˂ 0.01), low physical activity (OR = 1.84; p = 0.001), and poorer academic performance (OR = 0.83; p ˂ 0.01). Conclusions: Low adherence to the MD is significantly associated with increased likelihood of depression, anxiety, and excess body weight among university students in Greece. These findings underscore the importance of promoting healthy dietary habits and related lifestyle behaviors in young adult populations as a potential strategy for mental health prevention and intervention. Due to the presence of several limitations in the present study, future longitudinal and interventional studies should be performed to confirm the present findings. Full article

Background: Healthier between-meal snacks can improve diet quality in the US and globally. Objectives: To assess the impact on diet quality of replacing solid snacks with almonds or adding almonds (30 g) to the diet. Methods: Dietary data for 4333 children (4–19 y) and 10,925 adults (>19 y) came from the National Health and Nutrition Examination Survey (NHANES 2017–23). Nutrient composition data came from the Food and Nutrient Databases for Dietary Studies (FNDDS). Substitution Model 1 replaced all solid snacks with almonds on a per-calorie basis. Model 2 exempted “healthy” snacks. Model 3 added almonds to the observed diet. The Healthy Eating Index (HEI-2020), Nutrient Rich Food Index (NRF), Mean Adequacy Ratio (MAR), and Mean Excess Ratio (MER) were measures of diet quality. Results: Solid snacks provided 329 kcal/day (15.6% of dietary energy), of which 58 kcal came from healthy snacks (2.9%). The 4–13 y age group consumed the most energy from snacks. Diets with almonds replacing solid snacks were lower in added sugar, sodium, and saturated (solid) fat but higher in protein, fiber, mono- and polyunsaturated fats, and magnesium. MAR dietary nutrient density scores were significantly higher, and MER scores were lower. Total HEI-2020 scores rose from 52.4 (observed) to 59.6 (Model 1) and to 60.6 in Model 2_100. The addition of almonds (30 g or 50 g) increased HEI-2020 values to 59.2 and to 61.4, respectively. Several HEI-2020 sub-scores increased as well. The greatest dietary benefits were obtained for children and young adults. Conclusions: Replacing solid snacks with small amounts of almonds led to higher quality modeled food patterns, especially for younger age groups. The DGA 2025–30 should address the inclusion of healthy energy-dense snacks into everyday diets. Full article

Introduction: “The dog is a man’s best friend” and research has showed that this idea is extended beyond the degree of loyalty. Dog ownership has been linked to several positive health outcomes for the owner. The aim of the present cross-sectional case–control study was to assess differences in the physical activity level (PAL), body composition, quality of life (QoL), and diet quality and dietary knowledge between dog owners and non-owners. Methods: A total of 55 dog owners and an equal amount of non-dog owners (all aged between 18 and 60 years old) formed the case and control groups, respectively. Basic anthropometric measurements were performed, including body fat (BF) and diet, assessed with the Mediterranean Diet Score (MedDietScore) and the Eating Assessment Table (EAT). Physical activity was recorded for 3 consecutive days using activity monitors. QoL was evaluated using the brief version of the World Health Organization QoL (WHOQOL-BREF) tool. Results: The two groups demonstrated a similar PAL, but lower BF% (p = 0.009), hip circumference (p < 0.001), triceps (p = 0.012), and subscapular skinfolds (p = 0.003) were recorded among dog owners. The EAT score was greater among dog owners (p = 0.0023), indicating improved dietary intake and knowledge, even after adjustment for education attained and BMI (p = 0.026). On the other hand, greater adherence to the Mediterranean diet was exhibited among those not having dogs (p = 0.018). Regarding dog measurements and their owners’ anthropometry, dog neck circumference was negatively correlated to the owners’ biceps and triceps skinfolds (r = −0.327, p = 0.016; r = −0.320, p = 0.018, respectively). Additionally, dog breed size was negatively correlated to the owners’ triceps skinfold (r = −0.325, p = 0.015), sum of skinfolds (r = −0.311, p = 0.021), hip circumference (r = −0.341, p = 0.011), body fat (r = −0.357, p = 0.007), and fat mass index (r = −0.307, p = 0.023). Conclusions: Dog ownership is associated with improved body composition and smaller skinfold thickness at specific body sites, as well as with a more health-conscious lifestyle, including better diet quality and knowledge. Full article

Background/Objectives: Tooth loss is a key marker of ageing and is linked to functional, psychological, and nutritional decline. Removable dental prostheses (RDPs) are widely used, yet their impact on life satisfaction and oral health–related quality of life (OHRQoL) remains uncertain. This study aimed to: (1) identify dental deficiencies in adults aged ≥50 years; (2) assess the use of RDPs; and (3) examine the relationship between prosthetic status, life satisfaction, and OHRQoL. Methods: This retrospective cross-sectional analysis included 986 participants from the Białystok PLUS cohort (2018–2024). Dental examinations classified individuals into: Group 0 (no deficiencies), Group 1 (deficiencies without prostheses), and Group 2 (deficiencies with RDPs). Life satisfaction was measured using the Satisfaction with Life Scale (SWLS), and OHRQoL using the Geriatric Oral Health Assessment Index (GOHAI). Analyses included Kruskal–Wallis test and correspondence analysis. Results: Partial mandibular deficiencies were the most frequent and were less often rehabilitated than maxillary defects. Most prostheses were mucosa-supported. Life satisfaction (mean SWLS = 22.4) did not differ significantly between groups (p = 0.326). In contrast, OHRQoL differed significantly (mean GOHAI = 53.8; p = 0.0001), supporting an effect of prosthetic status. Group 0 showed the highest GOHAI scores (55.7), while Group 2 (52.7) scored lower than Group 1 (53.0). Prosthesis users most often reported dissatisfaction with appearance and eating comfort. Conclusions: Life satisfaction appears independent of prosthetic status. OHRQoL, however, is strongly associated with dentition: individuals without deficiencies report the highest outcomes, whereas RDPs—especially mucosa-supported types—do not improve, and may reduce, perceived OHRQoL. Full article

Poor diet is the leading preventable risk factor for death worldwide, associated with over 10 million premature deaths and USD 8 trillion related costs every year. Artificial intelligence or AI is rapidly emerging as the most historically disruptive, innovatively dynamic, rapidly scaled, cost-efficient, and economically productive technology (which is increasingly providing transformative countermeasures to these negative health trends, especially in low- and middle-income countries (LMICs) and underserved communities which bear the greatest burden from them). Yet widespread confusion persists among healthcare systems and policymakers on how to best identify, integrate, and evolve the safe, trusted, effective, affordable, and equitable AI solutions that are right for their communities, especially in public health nutrition. We therefore provide here the first known global, comprehensive, and actionable narrative review of the state of the art of AI-accelerated nutrition assessment and healthy eating for healthcare systems, generated by the first automated end-to-end empirical index for responsible health AI readiness and maturity: the Responsible Health AI readiness and Maturity Index (RHAMI). The index is built and the analysis and review conducted by a multi-national team spanning the Global North and South, consisting of front-line clinicians, ethicists, engineers, executives, administrators, public health practitioners, and policymakers. RHAMI analysis identified the top-performing healthcare systems and their nutrition AI, along with leading use cases including multimodal edge AI nutrition assessments as ambient intelligence, the strategic scaling of practical embedded precision nutrition platforms, and sovereign swarm agentic AI social networks for sustainable healthy diets. This index-based review is meant to facilitate standardized, continuous, automated, and real-time multi-disciplinary and multi-dimensional strategic planning, implementation, and optimization of AI capabilities and functionalities worldwide, aligned with healthcare systems’ strategic objectives, practical constraints, and local cultural values. The ultimate strategic objectives of the RHAMI’s application for AI-accelerated public health nutrition are to improve population health, financial efficiency, and societal equity through the global cooperation of the public and private sectors stretching across the Global North and South. Full article

Background/Objectives: Diet and physical activity are key lifestyle behaviours associated with sleep quality, yet their combined and sex-specific associations remain insufficiently understood. This study examined the associations between dietary behaviours and sleep quality among university students and assessed whether physical activity formed part of an indirect statistical association between these variables, with sex considered as a moderator. Methods: A cross-sectional study was conducted among 418 students (199 males, 219 females) from the Wroclaw University of Health and Sport Sciences. Body height and body mass were measured using standard anthropometric procedures. Sleep quality (SQ) was registered with the Pittsburgh Sleep Quality Index (PSQI), dietary habits were assessed with the Questionnaire of Eating Behaviours (QEB) and physical activity (PA) was assessed with the International Physical Activity Questionnaire (IPAQ). Data-driven feature-selection methods were applied to identify dietary behaviours associated with sleep quality, which were combined into a Synthetic Dietary Behaviour Index (SDBI). A moderated mediation model, adjusted for body mass index (BMI), was then used to examine the statistical associations between dietary behaviours, physical activity, sleep quality, and sex. Sleep quality was modelled as a continuous PSQI score in mediation analyses, while the dichotomised PSQI category was used only for feature selection. Results: Machine-learning feature selection identified nine dietary behaviours statistically associated with sleep quality. Unfavourable behaviours—fast food, fried meals, sweetened beverages, energy drinks and alcohol—were linked to poorer sleep, whereas vegetables, curd cheese and wholegrain bread were associated with better sleep. Poor sleep was more prevalent among females (45.2% vs. 14.6%, χ² (1) = 65.4, p < 0.001). The mediation model indicated that physical activity formed part of a statistically significant but modest indirect association between dietary behaviour and sleep quality, with sex moderating the IPAQ → PSQI path (β = −0.45, p = 0.006). Indirect associations were significant for both sexes but stronger among females (males: β = 0.032, p = 0.021; females: β = 0.102, p = 0.004). Conclusions: Unfavourable dietary patterns and lower physical activity were statistically associated with poorer sleep quality, with a stronger indirect statistical effect observed among females. These findings support the relevance of integrated, sex-sensitive lifestyle approaches addressing both dietary behaviours and physical activity, while acknowledging the cross-sectional nature of the data. Full article

Background: Dietary patterns influence systemic inflammation, which is involved in the pathogenesis of non-communicable diseases. The dietary inflammatory index (DII) quantifies the inflammatory potential of the diet and varies across populations due to cultural and regional eating habits. Limited data exist on the inflammatory potential of diets in Saudi Arabia. This study aimed to assess the inflammatory potential of the diet and its association with sociodemographic and lifestyle factors among adults in Saudi Arabia. Methods: A cross-sectional study included 256 adults aged 18–50 years residing in Saudi Arabia. Participants were recruited using convenience sampling via social media platforms. Data were collected between November 2024 and August 2025 using a validated Saudi food frequency questionnaire and sociodemographic survey. Energy-adjusted DII (E-DII) scores were calculated using 42 food parameters. Non-parametric tests (Mann–Whitney U and Kruskal–Wallis) were applied to examine associations between E-DII and sociodemographic variables. Results: Significant differences in E-DII were observed by sex (p < 0.001). Males had higher E-DII scores than females, suggesting more pro-inflammatory diets. Participants with postgraduate education tended to have lower E-DII than participants with only a high school degree, reflecting more anti-inflammatory dietary patterns. However, this trend was not statistically significant (p = 0.06). The mean E-DII was 4.8 ± 1.3, indicating a predominantly pro-inflammatory dietary pattern. No significant differences were found across age, education, income, BMI, marital status, employment, or smoking status. Conclusions: Sex was a key determinant of dietary inflammatory potential. Adults demonstrated overall pro-inflammatory dietary patterns in Saudi Arabia. Public health interventions should target higher risk groups, such as males with a higher risk of non-communicable diseases, to promote anti-inflammatory dietary habits and reduce chronic disease risk in this population. Full article

Background: Daily energy intake from snacking behaviors has increased over the past few decades, during which the prevalence of obesity and metabolic syndrome has risen to epidemic proportions. There remains considerable room for improvement in the overall quality of dietary intakes of the U.S. population when compared to national recommendations. Food cravings may contribute to the types of snacks chosen for consumption, and thus, the frequency of foods and food groups consumed, and the overall nutritional quality of the diet. Methods: Eighty-four young (28.5 ± 4.3 years) adults with at least one metabolic syndrome risk factor participated in a parallel-arm single-blind randomized trial designed to compare effects of consuming a mix of tree nuts versus typical high-carbohydrate food items as between-meal snacks for 16 weeks. Cravings for 28 common foods via the Food Craving Inventory, short-term dietary intakes via 24 h multi-pass methodology, food group frequency via the Rapid Eating Assessment for Participants, usual hunger and fullness via visual analog scales, appetite-regulating hormones, and diet quality via the Healthy Eating Index—2015 were measured at baseline and end of study. Results: Participants in the TNsnack group had significant decreases in cravings for high sweet items and fast-food items, which were associated with decreased frequency of desserts and salty foods along with increased intake of higher protein items. In contrast, no significant reductions in food cravings or preference for sweets were observed in the CHOsnack group. Decreased cravings for sweets by TNsnack participants were associated with increased total GLP-1 levels: cake (r = −0.35, p = 0.03), brownies (r = −0.44, p = 0.02), candy (r = −0.36, p = 0.03) and ice cream (r = −0.33, p = 0.04). Overall, the total diet quality score improved by 19% among TNsnack participants. Conclusions: Replacing more typical between-meal snacks with tree nuts may reduce food cravings, particularly for sweeter food items that are likely to be nutrient poor and energy dense. By reducing cravings and frequency of intake, consuming tree nuts as snacks could facilitate having a higher quality, more nutrient-dense diet and mitigate potential negative effects of snacking on metabolic health in young adults. Full article

Background: Body positivity is a social movement aimed at promoting acceptance and appreciation of diverse body types. Despite its growing popularity, its relationship with eating behaviors and body mass index (BMI) remains unclear. This study aimed to investigate the opinions of women attending fitness classes on the body positivity movement and to assess the association between these attitudes, eating behaviors, and BMI. Methods: A total of 118 women aged 18–65 years participated in the study. Data were collected using a self-developed body positivity questionnaire and the validated Polish version of the Three-Factor Eating Questionnaire (TFEQ-13). Participants were stratified into two groups based on BMI (<25 and ≥25 kg/m²). Results: No significant association was found between general attitudes toward body positivity and either eating behaviors or BMI. However, a positive correlation was observed between BMI and emotional eating as well as cognitive restraint. Women with higher BMI demonstrated greater cognitive restraint and tendencies toward emotional eating. Body acceptance was significantly lower in women with BMIs ≥ 25. Conclusions: While general attitudes toward the body positivity movement do not appear to influence eating behaviors directly, body weight is linked to both emotional eating and cognitive restraint. These findings underscore the complex relationship between psychological factors, eating patterns, and body image, suggesting the need for further research and tailored interventions promoting both health and self-acceptance. Full article

Background: The high prevalence of anxiety and depression among young adults constitutes a significant public health concern, with body image identified as a key psychological factor. However, the interplay between subjective metrics (perceived body image) and objective measures (Body Mass Index) remains insufficiently explored within specific populations, such as health sciences students in Eastern Europe. Methods: An observational, cross-sectional study was conducted on a sample of 137 medical and nursing students from a Romanian university. Validated instruments were employed: the Hospital Anxiety and Depression Scale (HADS) and the Eating Disorder Examination Questionnaire (EDE-Q). BMI was calculated from self-reported height and weight. Spearman’s correlation analyses and Mann–Whitney U tests were performed. Results: Subjective body image concerns, particularly those related to shape, weight, and eating, were found to be positively and significantly correlated with symptoms of anxiety and depression (all p < 0.05). In contrast, BMI exhibited no significant correlation with either of the HADS subscales. Although nursing students presented a higher mean BMI, no significant differences were recorded between the student groups with respect to psychological symptoms or body image concerns. Conclusions: Subjective dissatisfaction with body image is a more salient correlate of emotional distress than objective body mass in this cohort. Although the sample size was moderate, the observed associations were robust and statistically significant, underscoring the importance of subjective body image over objective metrics such as BMI in this academic population. These findings underscore the necessity for mental health interventions within university settings to focus on the perceptual and cognitive-affective aspects of body image, rather than exclusively on weight management. Full article

The COVID-19 pandemic and its associated economic stressors have profoundly reshaped consumer eating behaviors, presenting an urgent and underexplored challenge for the academic community. This interdisciplinary review critically examines how these disruptions have influenced both food approach and food avoidance patterns, offering a structured analysis of eight key behavioral parameters: Hunger (H), Food Responsiveness (FR), Emotional Overeating (EOE), Enjoyment of Food (EF), Satiety Responsiveness (SR), Emotional Under Eating (EUE), Food Fussiness (FF), and Slowness in Eating (SE). Drawing on recent literature, we highlight significant shifts in these traits—such as heightened hedonic hunger, age-related changes in food preferences, and gender-specific emotional-satiety dynamics—underscoring the complex interplay between emotional states, physiological cues, and behavioral tendencies. Grounded in the systematic examination of peer-reviewed studies in the post-COVID period, this review offers a robust and comprehensive synthesis of current evidence. The novelty of this work lies in its integration of findings into targeted proposition statements for each parameter, visually supported by original flow charts. These culminate in the development of a “Consumers’ Eating Behavior Index”—a conceptual tool designed to guide researchers, healthcare professionals, and policymakers in understanding and responding to post-pandemic dietary transformations. By emphasizing the emotional and psychological dimensions of eating, this index offers a timely framework for designing tailored public health interventions that promote sustainable nutritional habits. This study calls for renewed academic attention to the behavioral consequences of global crises, positioning eating behavior research as a critical frontier in post-COVID recovery and resilience. Full article