Search Results (719)

Background: The Dietary Guidelines for Americans (DGA) and the American Academy of Pediatrics recommend limiting 100% juice consumption to 0.5–1.25 cups/day and to no more than one half of total fruit intake. Objective: To explore the dietary benefits of consuming 100% fruit juice and diluted 100% juice across diverse socio-demographic strata in the US. Methods: Consumption patterns for 100% juice and diluted 100% juice were examined by sex, age group, income-to-poverty ratio (IPR), and race/ethnicity. Dietary intakes came from the National Health and Nutrition Examination Survey (NHANES 2017–2020 and 2021–2023). The Healthy Eating Index 2020 (HEI 2020) and diet-level Nutrient Rich Food (NRF9.3) scores were the two measures of diet quality. The amounts of 100% juice consumed were compared to published DGA recommendations. Results: The consumption of 100% juice was greatly below that of water, milk, and sugar-sweetened beverages (SSBs). The consumption of diluted 100% juice was very low. Consumers of 100% juice had higher HEI 2020 scores (53 vs. 48) and diets with less added sugar and more total fruit, more potassium, calcium, and vitamin C. About 88% of the NHANES sample consumed <4 oz/day (1/2 cup) of 100% juice and most derived at least 50% of fruit from whole fruit, though some variation by income and race/ethnicity was observed. About 93% of the sample consumed <1 cup/day (8 oz) of 100% juice. Lower income groups consumed less whole fruit and more 100% juice. Conclusion: The consumption of 100% fruit juice was a marker of healthier dietary choices. The observed social gradient suggests that 100% fruit juice may provide valuable nutrients to populations who may be unable to afford or access whole fruit. Public health recommendations: The consumption of 100% fruit juice by some population subgroups could be increased. Fruit juice was not displacing whole fruit, and current consumption was well below the current DGA recommended values. Full article

Background/Objectives: Suboptimal gestational weight gain (GWG) has been linked to increased risks of adverse maternal outcomes. Evidence linking diet in pregnancy to GWG remains limited. We assessed relationships between adherence to five dietary patterns (Planetary Health Diet [PHD], Dietary Approaches to Stop Hypertension [DASH], Alternate Mediterranean Diet [AMED], Healthy Eating Index [HEI], and Alternate Healthy Eating Index [AHEI]) and 2009 Institute of Medicine GWG categories. Methods: Women expecting singleton pregnancies participated in the NICHD Fetal Growth Studies and completed a food-frequency questionnaire (FFQ) at 8 to 13 weeks of gestation that captured their baseline diet. Adherence to each dietary pattern was calculated, with higher scores indicating greater adherence. Women were categorized into low, moderate or high adherence to each dietary pattern. Using multinomial logistic regression, we estimated adjusted odds ratios and 95% confidence intervals [OR (95% CIs)] of inadequate or excessive GWG (reference category: adequate), for high vs. low adherence to each dietary pattern. Results: In the full cohort, women with high vs. low adherence to DASH, AMED, HEI, or AHEI (but not PHD) had a 13% to 31% lowered odds of inadequate total GWG [ranging from 0.87 (0.58, 1.31) for AMED to 0.69 (0.48, 0.99) for DASH]. High adherence to DASH or HEI was associated with lower odds of inadequate first-trimester GWG, after correcting for multiple testing [DASH: 0.36 (0.22, 0.61), HEI: 0.49 (0.30, 0.79)]. No significant association was observed between any of the dietary patterns and excessive total and trimester-specific GWG. Conclusions: Greater adherence to several dietary patterns was associated with lowered odds of inadequate GWG. Future studies could characterize these diets objectively by identifying metabolite signatures and examining their associations with GWG. Full article

Diet and gut microbiota are significant determinants of host health, but how dietary quality modulates gut microbiota in Blastocystis-colonised individuals remains underexplored. We studied two contrasting cohorts: university students (FACSA, n = 46) and institutionalised children with their caregivers (PAVILA, n = 37), representing distinct dietary and sociodemographic contexts. Eight participants from each cohort tested positive for Blastocystis; however, two PAVILA samples could not be sequenced, resulting in a final microbiota subcohort of 14 individuals (FACSA n = 8, PAVILA n = 6). Dietary quality was assessed using the Healthy Eating Index-2020 (HEI-2020), and faecal microbiota was characterised through 16S rRNA sequencing. Alpha and beta diversity were analysed, and genus-level transformed data were further evaluated using permutational multivariate analysis of variance (PERMANOVA), principal coordinates analysis (PCoA), and distance-based redundancy analysis (db-RDA). The FACSA cohort exhibited higher microbial richness and diversity (Shannon and Simpson indexes, p < 0.01) compared to PAVILA, with marked differences in microbial composition (PERMANOVA R² = 0.39, p = 0.002). Total diet quality correlated with microbial structure (R² = 0.26, p = 0.016), with protein (R² = 0.23, p = 0.017) and vegetable components (R² = 0.17, p = 0.044) as primary contributors. Multivariate analysis showed that higher protein and vegetable intakes were associated with genera such as Sellimonas, Murimonas, Alistipes, and Desulfovibrio (FACSA group). In contrast, Hydrogenoanaerobacterium, V9D2013_group, and Haemophilus were linked to lower-quality diets (PAVILA group). Our results indicate that diet quality significantly influences gut microbiota composition in individuals colonised by Blastocystis, underscoring its potential as a target for nutritional interventions in vulnerable populations. Full article

Background/Objectives: Nurses play a vital role in healthcare, yet their demanding working conditions, including long hours, shift work, and stress, can negatively impact health behaviors. In Poland, empirical data on nurses’ eating habits and body composition remain limited. Therefore, this study aimed to evaluate body composition and dietary habits among nurses, and to identify significant relationships and associations between these variables. Methods: A cross-sectional observational study was conducted among 460 Polish nurses. The mean age of the respondents was 45.07 years (SD ± 11.98). Body composition was assessed using the Tanita MC-780 PLUS MA analyzer, and eating behaviors were measured with the standardized My Eating Habits questionnaire (MEH). Advanced statistical analyses including k-means clustering, ANOVA, chi-square tests, Spearman’s correlation, ROC curves, decision tree modeling, and heatmap visualization were used to identify associations. Results: The MEH scores among nurses indicated average eating behavior. However, excess body fat, overweight/obesity, shift work, and holding multiple jobs were significantly associated with emotional overeating, habitual overeating, and restrictive eating. Decision tree analysis identified Body Mass Index (BMI), fat-free mass (FFM) and comorbidities as key predictors of problematic eating patterns. Interaction effects showed that shift work combined with higher BMI further increased the risk of maladaptive behaviors. Heatmaps confirmed the strongest MEH scores in participants with elevated BMI and FFM. Conclusions: The findings underscore the need for targeted workplace interventions promoting healthy eating and weight control among nurses. Recognizing risk factors such as excess weight or multiple job holding can aid in designing effective prevention and health promotion strategies tailored to healthcare professionals. Full article

Background: Grain foods are important sources of complex carbohydrates, fiber, vitamins, and minerals. Objective: To identify healthy grain foods and to assess their associations with composite diet quality measures and selected health outcomes. Methods: Healthy grain foods were identified using two methods. The first one, Carbohydrate Food Quality Score (CFQS-3) was based on whole grains, fiber, and added sugar. The second, NRF9.3g score for grains, balanced nutrients to encourage (protein, fiber, vitamins B1, B2, B3, and E, folate, iron, and magnesium) against added sugar, sodium, and saturated fat. Nutrient composition data for 1244 grain foods came from the USDA Food and Nutrient Database for Dietary Studies (FNDDS 2017–2023). Dietary intakes came from the National Health and Nutrition Examination Surveys (NHANES 2017–2023). The Healthy Eating Index (HEI 2020) and the diet-level Nutrient Rich Food Index (NRF) were the two measures of diet quality. National food prices came from the USDA 2021 Thrifty Food Plan. Data on body weight, waist circumference, insulin, and cholesterol came from NHANES clinical files. Results: Healthy grain foods were those that scored >2 points on CFQS-3 or were in the top tertile of NRF9.3g scores. The CFQS-3 score favored cooked whole grains and cereals and savory snacks. The NRF9.3g score gave the highest ratings to breads, rolls, and RTE cereals. Consumers of healthy grains identified using both methods had higher HEI 2020 values and higher diet-level NRF scores. Both effects were dose-dependent. Consumption of healthy grains was associated with lower obesity rates and lower fasting insulin levels. Conclusions: Consumption of healthy grain foods was associated with healthier diets and lower obesity prevalence. Dietary guidelines need to acknowledge the contribution of healthy grain foods to diet quality and health. Full article

Background: Emotional eating, defined as the tendency to eat in response to emotions, has been associated with various biopsychosocial factors. However, in the Peruvian context, there is limited evidence regarding the specific predictors of this eating behavior in adolescents. Objective: To examine the associations between saturated fat intake, sleep duration, body mass index (BMI), depressive symptoms, age and sex, and emotional eating in Peruvian adolescents. Methods: This was a predictive cross-sectional study based on non-probabilistic sampling. A total of 722 adolescents from four schools located in East Lima were included. A multiple linear regression model was employed to examine the relationships between age, sex, saturated fat intake (SFI), sleep duration, BMI, and depressive symptoms and emotional eating. Results: The model was statistically significant (adjusted R² = 0.301; F = 45.276; p < 0.001), explaining 30.1% of the variance in emotional eating based on the explanatory variables. Being female (β = 0.208; p = 0.011), aged 15 to 18 versus 12 to 14 years (β = 0.083; p < 0.001), having a high SFI (β = 0.186; p < 0.001), sleeping ≥ 7 h (β = −0.126; p < 0.001), and a higher BMI (β = −0.082; p = 0.011) were significantly associated with emotional eating. Depressive symptoms (β = 0.365; p < 0.001) emerged as the strongest predictor in the model. Conclusions: Emotional eating among Peruvian adolescents is associated with psychological, behavioral, and sociodemographic factors. Depressive symptoms showed the strongest association, while longer sleep duration was linked to lower emotional eating scores. These findings highlight the need for integrated interventions targeting mental health, sleep hygiene, and healthy dietary behaviors in adolescents. Full article

Technological innovation in immersive virtual reality is fostering the development of novel psychotherapeutic interventions in mental health, particularly benefiting populations with limited access to specialized services. This pilot study explores the feasibility, tolerability, and therapeutic potential of an immersive virtual reality-based psychotherapeutic intervention for adolescents and young people with eating disorders in a rural setting. A quasi-experimental pre-test/post-test design was used, with a control group (n = 5) and an experimental group (n = 5), applying weekly immersive virtual reality sessions focused on body perception and food exposure. Preliminary results showed good acceptance and a low incidence of cybersickness. However, a reduction in anxiety levels was observed in the experimental group after immersive virtual reality exposure, particularly in trait anxiety, suggesting a potential effect of the intervention on emotional regulation. While these changes were not statistically significant, the direction and magnitude of the effect warrant further investigation. Changes in body mass index were also noted during the intervention. The remotely guided sessions, conducted via fifth-generation mobile network connectivity, demonstrated technical feasibility and encouraging clinical outcomes, even in geographically isolated or underserved areas. These findings support the use of immersive VR as a complementary tool in the early stages of treatment for eating disorders, contributing to improved body perception and emotional self-regulation. This work not only reinforces the applicability of immersive technology in real-world clinical practice but also opens new avenues for the development of personalized, accessible, and emotionally meaningful interventions in child and adolescent mental health. Full article

Aims: To investigate the nutritional status and feeding behaviours of nursing home residents and the impact of cognitive impairments and feeding difficulties on nutritional health. Design: A cross-sectional observational design was employed. Methods: The study assessed 51 nursing home residents using the Mini Nutritional Assessment Short-Form (MNA-SF) for nutritional status, the Feeding Difficulty Index (FDI) for mealtime behaviours, and the MoCA (Montreal Cognitive Assessment or The MoCA Test) for cognitive function. Results: The average age of participants was 87.8 years. Nearly half (47.1%) were at high risk of malnutrition, and 13.7% were classified as malnourished. The average MoCA score was 14, indicating moderate cognitive impairment, which was inversely associated with nutritional status. Feeding difficulties were common, as follows: 74.5% of residents paused feeding for over one minute, and 62.8% were distracted during meals. A longer duration of nursing home residency was associated with poorer nutritional outcomes. Overall, 65% of residents required mealtime assistance, with higher FDI scores correlating with greater support needs. Significant positive correlations were found between cognitive function and nutritional status (r = 0.401, p = 0.037) and between food intake and nutritional status (r = 0.392, p = 0.004). In contrast, residency duration (r = −0.292, p = 0.037) and feeding difficulties (r = −0.630, p < 0.001) were negatively associated with MNA-SF scores. FDI scores were strongly associated with the level of assistance required during meals (r = 0.763, p < 0.001). This study highlights the critical need for targeted nutritional assessments and interventions in nursing homes, especially for residents with dementia facing cognitive impairments and feeding difficulties. Enhancing staff training on recognising and addressing eating challenges and risk factors is essential for improving nutritional well-being. Conclusions: The study highlighted the profound impact of cognitive impairments and feeding difficulties on the nutritional health of nursing home residents, indicating a high prevalence of malnutrition and a need for comprehensive mealtime assistance. Full article

Background: Findings from the NutriNet-Santé studies have been used to drive public health policy in France, the European Union, and globally. The fact that NutriNet-Santé studies are not generalizable is a matter of concern. Objectives: We aimed to compare the characteristics and diet quality of consumers and non-consumers of low-calorie sweeteners (LCS) within the National Health and Nutrition Examination Survey (NHANES) sample to published within-cohort findings from NutriNet Santé. Methods: Dietary intake data for the US from two 24 h dietary recalls in 4 cycles of the NHANES 2011-18 study (n = 17,252) were used to identify LCS consumers and non-consumers. Results: LCS consumers in NHANES were more likely to be overweight, were of higher education and incomes, and had lower intakes of added sugar and higher HEI 2020 diet quality scores compared to LCS non-consumers. Based on published reports, higher LCS consumers in NutriNet Santé were normal weight, did not differ in education, did not consume less added sugar, and had lower quality diets overall. Whereas LCS consumers in NHANES were less likely to be current smokers, higher LCS consumers in NutriNet Santé were more likely to be current smokers. Based on published estimates, mean aspartame intake in NutriNet Santé was only 3 mg/day (0.045 mg/kg/day) for lower consumers and 47 mg/day (0.71 mg/kg/day) for higher consumers. Conclusions: Minimal LCS exposure and likely floor effects can be sources of statistical biases in studies of diet and health. NutriNet Santé is a large volunteer cohort of thin, educated, weight conscious French women who diet and smoke. Extreme caution is warranted when findings from atypical and non-representative samples are used to support policies in global public health. Full article

Background: Super morbid obesity (SMO), defined as a body mass index (BMI) ≥ 50 kg/m², represents a distinct and increasingly prevalent subgroup of patients undergoing bariatric surgery. Compared to individuals with lower BMI, patients with BMI ≥ 50 kg/m² often exhibit unique clinical, psychological, and social characteristics that may influence treatment outcomes. Objective: This study aimed to compare demographic, metabolic, and psychiatric profiles of patients with BMI ≥ 50 kg/m² and non-super morbid obesity (NSMO; BMI < 50 kg/m²) who were evaluated prior to bariatric surgery. Methods: A total of 319 patients were recruited between December 2022 and December 2023 at a bariatric center in Gdansk, Poland. All participants underwent a comprehensive preoperative assessment, including laboratory testing, psychometric screening (BDI, PHQ-9), and psychiatric interviews. Patients were stratified into class IV obesity and NSMO groups for comparative analysis. Results: Patients with BMI ≥ 50 kg/m² were significantly older and more likely to report a history of lifelong obesity, family history of obesity, and childhood trauma. They had higher rates of obesity-related health problems such as hypertension, obstructive sleep apnea, and chronic venous insufficiency, as well as worse liver function and lipid profiles. Although the overall psychiatric burden was high in both groups, patients with BMI ≥ 50 kg/m² reported fewer prior diagnoses of depression and eating disorders, despite similar scores on screening tools. Conclusions: Patients with BMI ≥ 50 kg/m² represent a clinically distinct population with elevated metabolic risk, complex psychosocial backgrounds, and possibly underrecognized psychiatric burden. These findings underscore the need for multidisciplinary preoperative assessment and individualized treatment strategies in this group of patients. Full article

Background/Objectives: The aim of this study was to evaluate baseline health measurements among transitional housing residents (n = 29) participating in an 8-week pilot wellness intervention. Methods: Researchers measured anthropometrics, body composition, muscular strength, cardiovascular indicators, physical activity, diet quality, and health-related perceptions. Researchers analyzed data using descriptive statistics and conventional content analysis. Results: Most participants were male, White, and food insecure. Mean BMI (31.8 ± 8.6 kg/m²), waist-to-hip ratio (1.0 ± 0.1 males, 0.9 ± 0.1 females), body fat percentage (25.8 ± 6.1% males, 40.5 ± 9.4% females), blood pressure (131.8 ± 17.9/85.2 ± 13.3 mmHg), and daily step counts exceeded recommended levels. Absolute grip strength (77.1 ± 19.4 kg males, 53.0 ± 15.7 kg females) and perceived general health were below reference standards. The Healthy Eating Index-2020 score (39.7/100) indicated low diet quality. Common barriers to healthy eating were financial constraints (29.6%) and limited cooking/storage facilities (29.6%), as well as to exercise, physical impediments (14.8%). Conclusions: Residents living in transitional housing have less favorable body composition, diet, and grip strength measures, putting them at risk for negative health outcomes. Wellness interventions aimed at promoting improved health-related outcomes while addressing common barriers to proper diet and exercise among transitional housing residents are warranted. Full article

Background/Introduction: Psychological inflexibility, which includes experiential avoidance, is a transdiagnostic process associated with multiple mental health issues in adolescence. Physical fitness (PF) has shown benefits for mental well-being, yet its specific relationship with psychological inflexibility remains understudied, particularly among youth. Objectives: To examine the association between components of PF and psychological inflexibility, measured by the Acceptance and Action Questionnaire-II (AAQ-II), in a representative sample of Spanish adolescents. Methods: A cross-sectional analysis was conducted using data from 631 adolescents (aged 12–17) participating in the Eating Healthy and Daily Life Activities (EHDLA) study. PF was assessed by the Assessing the Levels of PHysical Activity and Fitness (ALPHA-Fit) Test Battery (cardiorespiratory fitness, muscular strength, agility, and flexibility). Psychological inflexibility was measured using the AAQ-II. Generalized linear models (GLMs) were used to evaluate associations, adjusting for age, sex, body mass index, socioeconomic status, physical activity, sedentary behavior, sleep duration, and energy intake. Results: Unadjusted analyses showed weak but significant associations between psychological inflexibility and performance in the 20 m shuttle run test (p = 0.002), the 4 × 10 shuttle run test (p = 0.005), and the sit-and-reach test (p < 0.001). However, after adjusting for covariates, none of the PF components maintained a statistically significant association with the AAQ-II scores. Conclusions: In this adolescent sample, PF components were not independently associated with psychological inflexibility after adjustment for key confounders. These findings suggest that, while PF may contribute to general well-being, it is not a primary determinant of psychological inflexibility. Further longitudinal and intervention studies are needed to clarify the mechanisms linking physical and psychological health in youth. Full article

The purpose of this study was to examine vegetable consumption and its relationship with lifestyle characteristics among children and adolescents. Data from a health survey administered to a representative sample of 177,091 schoolchildren between the ages of 8 and 17 were employed in this observational, cross-sectional investigation. Physical activity level, screen time, and sleeping patterns were assessed using self-completed questionnaires. Vegetable consumption and dietary habits were analyzed using the Mediterranean Diet Quality Index for Children and Adolescents. Participants consuming vegetables more than once daily were categorized as consumers vs. non-consumers. Physical education teachers measured anthropometric and physical fitness factors. Descriptive statistics and binary logistic regression analysis were conducted, and the odds ratio with the corresponding 95% confidence interval was calculated and adjusted for confounders. Vegetables were consumed once or more times a day by more females than males (25.5% vs. 24.0%, p < 0.001). In both sexes, vegetable consumers slept more, ate healthier, spent less time on screens, and had better anthropometric and aerobic fitness measurements than non-consumers. Healthy eating practices, such as regularly consuming fruits, legumes, nuts, and dairy products, were strongly correlated with vegetable intake. For every one-year increase in age, the odds of being a vegetable consumer decreased by 8% and 10% in boys and girls, respectively. Overweight/obese participants had lower odds of being a vegetable consumer by 20%. Increased screen time, inadequate physical activity, and insufficient sleeping hours decreased the odds of being a vegetable consumer by 22%, 30%, and 25%, respectively (all p-values < 0.001). Overall, a healthier lifestyle profile was associated with higher vegetable intake for both sexes among children and adolescents. Full article

Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net carbohydrate intake to 50 g per day, prioritizing unsaturated fats, and reducing saturated fat intake. However, adherence to the HKD remains a challenge in urban, time-constrained environments. Therefore, this pilot randomized controlled trial aimed to investigate the effects of Healthy Ketogenic Diet Ready-To-Eat (HKD-RTE) meals (provided for the first month only) versus HKD alone on weight loss and metabolic parameters among overweight adults. Methods: Multi-ethnic Asian adults (n = 50) with a body mass index (BMI) ≥ 27.5 kg/m² were randomized into the HKD-RTE group (n = 24) and the HKD group (n = 26). Both groups followed the HKD for six months, with the HKD-RTE group receiving HKD-RTE meals during the first month. Five in-person workshops and mobile health coaching through the Nutritionist Buddy Keto app helped to facilitate dietary adherence. The primary outcome was the change in body weight at 6 months. Linear regression was performed on the change from baseline for each continuous outcome, adjusting for demographics and relevant covariates. Logistic regression was performed on binary weight loss ≥ 5%, adjusting for demographics and relevant covariates. Results: In the HKD group, participants’ adherence to the 50 g net carbohydrate target was 15 days, while that in the HKD-RTE group was 19 days over a period of 30 days. Participants’ adherence to calorie targets was 21 days in the HKD group and 23 days in the HKD-RTE. The average compliance with the HKD-RTE meals provided in the HKD-RTE group was 55%. The HKD-RTE group experienced a greater percentage weight loss at 1 month (−4.8 ± 3.0% vs. −1.8 ± 6.2%), although this was not statistically significant. This trend continued up to 6 months, with the HKD-RTE group showing a greater percentage weight reduction (−8.6 ± 6.8% vs. −3.9 ± 8.6%; p = 0.092). At 6 months, the HKD-RTE group had a greater reduction in total cholesterol (−0.54 ± 0.76 mmol/L vs. −0.05 ± 0.56 mmol/L; p = 0.283) and LDL-C (−0.43 ± 0.67 mmol/L vs. −0.03 ± 0.52 mmol/L; p = 0.374) compared to the HKD group. Additionally, the HKD-RTE group exhibited greater reductions in systolic blood pressure (−8.3 ± 9.7 mmHg vs. −5.3 ± 11.0 mmHg), diastolic blood pressure (−7.7 ± 8.8 mmHg vs. −2.0 ± 7.0 mmHg), and HbA1c (−0.3 ± 0.5% vs. −0.1 ± 0.4%) than the HKD group (not statistically significant for any). Conclusions: Both HKD-RTE and HKD led to weight loss and improved metabolic profiles. The HKD-RTE group tended to show more favorable outcomes. Short-term HKD-RTE meal provision may enhance initial weight loss, with sustained long-term effects. 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