Search Results (59)

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

Ergothioneine is a diet-derived antioxidant with emerging evidence of neuroprotective benefits, but no dose-ranging study has evaluated its effects in healthy older adults. In this 16-week randomized, double-blind, placebo-controlled trial, 147 adults aged 55–79 with subjective memory complaints received ergothioneine (10 mg or 25 mg/day ErgoActive^®) or placebo. The primary outcome was the change in composite memory (CNS Vital Signs). Secondary outcomes included other cognitive domains, subjective memory and sleep quality, and blood biomarkers. At baseline, participants showed slightly above-average cognitive function (neurocognitive index median = 105), with plasma ergothioneine levels of median = 1154 nM (interquartile range = 889.9). Plasma ergothioneine increased by ~3- and ~6-fold for 10 mg, and ~6- and ~16-fold for 25 mg, at weeks 4 and 16, respectively (p < 0.001). 25 mg ergothioneine showed a within-group improvement in composite memory at week 4 (p < 0.05), although this was not sustained. Reaction time improved in both groups, dependent on time. Other domains showed null or limited effects. Subjective prospective memory and sleep initiation improved dose-dependently, with significant effects at 25 mg (p < 0.05). Liver function improved and a within-group increase in telomere length was noted. In conclusion, ergothioneine supplementation was safe and well tolerated, with evidence suggesting some benefits in this cohort of healthy older adults. Longer trials in individuals with lower baseline ergothioneine or cognitive function are warranted. Full article

Background/Objectives: The EAT-Lancet Commission proposed a healthy and sustainable ‘planetary health diet’ (PHD) based on the nutritional needs of adults, but recommended for all population groups over the age of two years. This study investigated the extent to which UK adolescent diets meet these recommendations, and the association between meeting recommendations and nutritional intake. Methods: Dietary intake data collected from students aged 11–15 years between 2019 and 2022 as part of the Food provision, cUlture and Environment in secondary schooLs (FUEL) study was used. Specifically, 24 h intakes of food groups and key nutrients were summarised for each participant, and micronutrient intake was expressed as a percentage of the reference nutrient intake (RNI). The proportion of participants meeting each PHD recommendation was calculated. A PHD index score was developed to measure the overall adherence to recommendations. Multilevel linear regression models were fitted to explore the association between the PHD score and intake of each nutrient. Results: No participants fully met the recommendations. The mean PHD score was 14.2 (3.3) out of 39. Adherence was low for the emphasised foods, and lowest for nuts (1.3%) and unsaturated oils (0.2%). Higher PHD index scores were associated with lower intakes of all micronutrients, with the largest association for vitamin B12 [regression coefficient: −12.9% (95% CI: −16.3, −9.4) of RNI] and the smallest for vitamin D [regression coefficient: −0.4 (95% CI: −0.7, −0.2) of RNI]. Conclusions: Substantial dietary changes are needed for this population group to meet the PHD guidelines. Further research should focus on why these recommendations may lead to the inadequate intake of some nutrients in this age group. We propose that the PHD guidance needs to be reviewed and potentially adapted for this specific population, with consideration of the typical dietary behaviours of this age group. Full article

Background/Objectives: Recent decades have seen a remarkable westernization of diets and a decline in adherence to the Mediterranean diet (MD). This study examined the eating habits of a representative sample of Italian university students to identify the determinants of adherence to the MD and the most relevant actions to improve their well-being. Methods: The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) and Sustainable Healthy Diet (SHED) index questionnaires were used to explore MD adherence as the primary outcome, and dietary behavior sustainability, respectively. Sociodemographic, anthropometric, and lifestyle information was also collected. Results: The final sample included 1434 subjects (18–24; 60% female). The median (IQR) KIDMED score was 6.0 (4.0–8.0) and 33% showed a high adherence to the MD. Having breakfast, eating fruit and vegetables at least once a day, consuming pasta or other grains almost daily, and using olive oil at home were among the most common positive aspects of students’ diets. However, regular consumption of fish, nuts, legumes, dairy products, and a second serving of fruit and vegetables was less prevalent. Having an active lifestyle, eating more plant products, and having more sustainable dietary behaviors in terms of the SHED index, were the main determinants of a high KIDMED score. Likewise, graduate students, daily consumers of plant-based meat alternatives, and students attending university canteens daily were more likely to adopt healthier diets. Conclusions: Future actions are crucial to create a food environment that facilitates healthy and sustainable dietary choices among young adults, such as improving the nutritional quality of processed products and regulating their promotion, as well as implementing initiatives to improve university food services and encourage the use of campus dining facilities. Full article

This study evaluates the effects of dietary selenium (Se) sources—sodium selenite (SS), nano-selenium (Nano-Se), selenocysteine (Se-C), and selenomethionine (Se-Met)—on production performance, egg quality, preservation characteristics, yolk Se content, and antioxidant capacity in Hy-Line Grey laying hens. A total of 450 healthy 18-week-old Hy-Line Grey laying hens were allocated to five groups (basal diet without Se, 0.30 mg/kg SS, Nano-Se, Se-C, or Se-Met) for an 8-week trial after a 4-week Se-depletion phase. The key results demonstrate that while no significant differences were observed in the feed intake, egg production rate, or egg weight among the groups (p > 0.05), organic Se (Se-C, Se-Met) and Nano-Se significantly improved the yolk color (p < 0.05) and yolk index (p < 0.05) and mitigated declines in the albumen height and Haugh unit during storage. Notably, Nano-Se exhibited superior efficacy in enhancing yolk color and antioxidant enzyme activity (p < 0.05). Furthermore, organic Se and Nano-Se increased yolk Se deposition (p < 0.05), increased yolk antioxidant enzyme activity (p < 0.05), and reduced lipid peroxidation (p < 0.05). These findings indicate that supplementing 0.3 mg/kg organic Se or Nano-Se enhances egg quality, extends shelf life, and improves antioxidant capacity, offering a sustainable strategy for selenium-enriched egg production. Full article

Objectives: This longitudinal study measured changes in adherence to sustainable healthy diets in 698 Chilean children (aged 3–6 years at baseline) over the period that Chile’s Food Labelling and Advertising Law was implemented. Methods: Dietary data were collected annually from 2016 to 2019 applying single multiple-pass 24 h dietary recalls to children’s primary caretakers. The Planetary Health Diet Index for Children and Adolescents (PHDI-C) was used to quantify adherence to sustainable healthy diets where higher scores indicate better adherence. Linear mixed models were fitted to estimate the change in PHDI-C total and individual component scores from 2016 to 2019. Results: Mean total PHDI-C score decreased from 50.1 points in 2016 to 46.3 and 46.1 in 2018 and 2019, respectively (p-value < 0.001), suggesting that children’s overall adherence to sustainable healthy diets was low and decreased over time. Intake of legumes, fruits, dark green vegetables, red and orange vegetables, and vegetable oils decreased, while intake of palm oil, red meats, and animal fats increased, resulting in small but significant declines in eight PHDI-C component scores. Whole cereal intake increased, while the consumption of dairy products and added sugars decreased, resulting in improvements in three PHDI-C component scores. Conclusions: Aside from the decrease in added sugar intake, all dietary changes observed in this study were consistent with trends described among children transitioning from pre-school age to school age. The Law might have contributed to reducing children’s added sugar intake, but further research is required to establish causality. Full article

Background/Objectives. Traditional dietary patterns are being abandoned in Mediterranean countries, especially among younger generations. This study aimed to investigate the potential lifestyle determinants that can increase adherence to the Mediterranean diet in children and adolescents. Methods. This study is a cross-sectional analysis of data from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU-funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean Diet and LIfestyle in Children and adolescents through behavIOUral change actionS). This study comprised information on 2011 children and adolescents aged 6–17 years old collected during 2023. The main background characteristics of both children and parents, including age, sex, education, and family situation, were collected. Children’s eating (i.e., breakfast, place of eating, etc.) and lifestyle habits (i.e., physical activity level, sleep, and screen time) were also investigated. The level of adherence to the Mediterranean diet was assessed using the KIDMED index. Logistic regression analyses were performed to test for likelihood of higher adherence to the Mediterranean diet. Results. Major determinants of higher adherence to the Mediterranean diet were younger age, higher physical activity level, adequate sleep duration, and, among dietary habits, having breakfast and eating with family members and at school. Parents’ younger age and higher education were also determinants of higher adherence. Multivariate adjusted analyses showed that an overall healthier lifestyle and parents’ education were the factors independently associated with higher adherence to the Mediterranean diet. Conclusions. Higher adherence to the Mediterranean diet in children and adolescents living in the Mediterranean area is part of an overall healthy lifestyle possibly depending on parents’ cultural background. Full article

Developing a sustainable feed with minimal or no fishmeal in tilapia production is a challenge to this industry. New Technology Promoter Binder (NTPB), a guanidinoacetic acid, is a nutritional supplement to enhance the energy metabolism of the muscle and brain tissue of vertebrates. This study aimed to evaluate several plant-based diet formulations with zero and minimal use of fishmeal enriched with NTPB on the growth, feed efficiency, and health status of Tilapia sp. The experimental diets in this study were conducted based on four formulations (minimum fishmeal/FM and zero fishmeal/NFM-based diets) with 0, 0.6, and 1.2 g·kg⁻¹ feed of NTPB supplementation. The research indicated that the various diets given to tilapia affected the growth performance of fish in terms of growth parameters and feed efficiency. Tilapias fed with NTPB grew better than those without NTPB in both FM- and NFM-based diets. The addition of NTPB was safe for tilapia as demonstrated in the blood glucose, urea, and creatinine levels, which were normal for healthy fish. The viscerosomatic and hepatosomatic indexes of tilapia fed with the experimental diets showed no distinct differences. Adding NTPB to tilapia diets increased the hardness and amino acid contents of the tilapia’s muscle, which would benefit consumers. Full article

Background: Extra virgin olive oil is a fundamental component of the Mediterranean diet. It contains several molecules that sustain human well-being by modulating cellular metabolism and exerting antioxidant, anti-inflammatory, and anti-ageing effects to protect normal tissues, and it can exert anti-angiogenic and pro-apoptotic effects on cancer cells. Metabolites found in different parts of the olive tree, including leaves, also possess properties that might help in cancer prevention and promote wellness in aging. Olive mill wastewater (OMWW), a liquid residue produced during olive oil extraction, represents an environmental issue. However, it is rich in phytochemicals with potential beneficial properties. Dietary supplements based on OMWW can be produced for nutritional supplementation with advantages to the ecology. Purpose: This work aims to measure hematochemical, anthropometric, and metabolomic parameters in volunteers taking an OMWW dietary supplement, Oliphenolia^® (OMWW-OL). Methods: The supplementation of OMWW-OL 25 mL twice daily for 30 days was tested on a pilot cohort of volunteers with characteristics close to metabolic syndrome. Hematochemical, anthropometric, serum biomarkers and serum metabolomic parameters were analyzed before the intervention, at 30 days, and 30 days after stopping consumption. Results: A total of 29 volunteers were enrolled, and 23 completed the study. The participants’ parameters at baseline were measured, and then twice daily at 30 days of treatment and 30 days after assumption discontinuation. Although treatment was with an olive derivative, their weight did not increase. Their body mass index, instead of augmenting, slightly decreased, particularly in the women. Also, hydration increased, especially in the women, while blood pressure, glycemia, and insulin decreased. Cholesterol, high-density lipoproteins, and triglycerides were stable, and LDL levels decreased, while vitamin D levels, alongside calcium, perceptibly increased. Albumin also increased. All the values were in support of an equilibrium, with no damaging effects. By mass spectrometry analysis, we also found favorable changes in the vitamin D/histamine and homocysteine/methionine ratios, an increase in a new metabolite of unknown formula, and the vitamin D/unknown metabolite ratio. Conclusions: Supplementation of OMWW-OL has no detrimental effects and might imply the beneficial modulation of several biological parameters. Although this is a small pilot study, with limited potency, it preliminarily suggests that the OMWW extract use could be potentially valuable for people at risk of metabolic syndrome. Some of these parameters could also be relevant in supporting healthy ageing and in cancer prevention. Full article

Dietary inorganic nitrate lowers blood pressure (BP) in healthy individuals through improved nitric oxide (NO) bioavailability. However, there is limited evidence examining the long-term effects of dietary nitrate for managing hypertension. We aimed to determine whether the sustained intake of dietary nitrate improved BP and cardiovascular disease (CVD) risk factors in individuals with early-stage hypertension. The Dietary Nitrate (NO₃) on BP and CVD Risk Factors (DINO₃) Trial was a multi-center, double-blinded, parallel, randomized, controlled trial in participants with elevated BP. Participants were supplemented with high-nitrate (HN) (~400 mg nitrate) or low-nitrate (LN) vegetable powder (~50 mg nitrate) on top of their usual diets for 16 weeks. The primary outcome was office systolic BP at 16 weeks. The secondary outcomes were 24 h ambulatory BP, central BP, heart-rate-corrected augmentation index (AIx75), carotid–femoral pulse wave velocity (cf-PWV), lipids, and high-sensitivity C-reactive protein (hs-CRP). Sixty-six participants were randomized at baseline (39M:27F, age: 51.5 ± 10.8 years, BMI:27.9 ± 3.2 kg/m²). In an intention-to-treat analysis, no differences were observed between HN and LN groups in terms of office systolic BP at 16 weeks (3.91 ± 3.52 mmHg, p = 0.27) or secondary outcomes. In this exploratory study, sustained HN vegetable supplementation did not exhibit more favorable vascular effects than LN vegetable supplementation in individuals with elevated BP. Full article

This study aimed to investigate the change in diet quality in addition to dietary adherence to the planetary health diet during night shifts in healthcare workers. This observational follow-up study involved 450 healthcare workers working night shifts (327 females, 123 males). A survey form requesting sociodemographic information (gender, age, marital status), job title, sleeping duration during the night shift, 24 h dietary records for pre-night-shift, during night shift, and post-night-shift, and anthropometric measurements (body weight and height) was applied. The scores of the Planetary Health Diet Index (PHDI) and the Healthy Eating Index 2020 (HEI-2020) were calculated according to the dietary records. The total HEI-2020 and PHDI scores decreased significantly (p < 0.05) during the night shift (44.0 ± 8.8 and 48.3 ± 13.2, respectively) compared to pre-night-shift (46.1 ± 9.2 and 51.9 ± 13.4, respectively) and increased post-night-shift (44.7 ± 9.9 and 50.6 ± 14.9, respectively), with no statistically significant difference between pre- and post-night-shift. There was a significant main effect of night shift working on total PHDI (F(896, 2) = 8.208, p < 0.001, η_p² = 0.018) and HEI-2020 scores (F(894, 2) = 6.277, p = 0.002, η_p² = 0.014). Despite healthcare workers’ knowledge of health factors, night shifts lead to poor dietary choices. To improve diet quality and sustainability, it is crucial to enhance access to healthy food options in their work environment. Full article

Poor dietary choices have been rising concurrently with an increase in asthma prevalence, especially in children. Dietary indexes that simultaneously measure the healthiness and sustainability of dietary patterns have emerged to address the dual concerns of human and planetary health. Accordingly, we aimed to evaluate adherence to a sustainable dietary pattern and its impact on airway inflammation and asthma. In this study, 660 school-aged children (49.1% females, 7–12 years) were considered. A cross-sectional analysis was performed to assess the association between diet and asthma and airway inflammation according to overweight/obesity. Diet was evaluated through the Planetary Health Diet Index (PHDI). Higher scores represent a healthier and more sustainable diet. Three definitions of asthma were considered based on a self-reported medical diagnosis, symptoms, asthma medication, measured lung function, and airway reversibility. Airway inflammation was assessed by exhaled fractional nitric oxide (eNO). We considered two categories of body mass index: non-overweight/non-obese and overweight/obese. The associations between diet with asthma and airway inflammation were estimated using adjusted binary logistic regressions. The odds of having airway inflammation decreased with the increase in PHDI score. Moreover, children in the non-overweight/non-obesity group in the fourth quartile of the PHDI had lower odds of having airway inflammation compared to children in the first quartile. Our study indicates that a healthier and sustainable diet is associated with lower levels of eNO, but only among children without overweight/obesity. Full article

Food neophobia has been defined as the reluctance to try new foods. Food neophobia is common in children and older people, but until now, scarce research has been carried out on food neophobia in the adult population. The aim of this study was to assess the most usual food neophobias in Spanish adults with overweight and obesity by sex, and their association with sociodemographic factors and the most prevalent chronic diseases. A cross-sectional observational study was carried out on adults (mean age of 43.5 ± 13.7 years old; n = 590; 50% female) with overweight or obesity. Their anthropometrics, adherence to the Mediterranean diet, age, educational level, economic level, smoking and sleeping habits, physical activity, chronic diseases, and food neophobias were assessed. The highest food neophobias in Spanish adults with overweight or obesity were directed toward vegetables, meat, fish, pulses, game meat, and fruits, mostly among females, with differences between sexes. Phobias of the soft texture of foods were also observed, without differences between sexes. Age, educational level, sleeping habits, and physical activity were directly related, and economical level and smoking were inversely related to food neophobia, mainly to healthy foods, and more obvious in males than in females. There were associations between body mass index (BMI) and chronic diseases and food neophobia. Adherence to the adaption of healthy and sustainable diets is low within food neophobics, increasing the risk of diet-related chronic diseases. Full article

There are studies on the effect of general nutrition education on diet quality and anthropometric measurements, while studies showing the effectiveness of sustainable nutrition education, which also addresses the effect of food on the environment, are quite limited. This study aimed to investigate the effects of sustainable nutrition education on diet quality, anthropometric measurements, and the carbon footprint (CFP) and water footprint (WFP) of diet. A total of 160 university students received 1 h of sustainable nutrition education for 6 weeks. Before, at the end of, and 2 months after the courses, 24 h food consumption records were taken to assess diet quality and CFP and WFP values of diet, and Mediterranean diet (MedDiet) and Healthy Eating Index (HEI)-2020 scores were evaluated. The results of the study showed that sustainable nutrition education increased MedDiet score by 1.86 points and HEI-2020 score by 7.38 points. This education program also decreased body weight, body mass index (BMI), fat mass, and neck circumference. Sustainability education has a positive impact on calcium, potassium, and magnesium intakes, a negative impact on vitamin B12 and zinc intakes, and no effect on total protein intake. Education resulted in a 22% reduction in CFP and a 10% reduction in WFP. Full article

This study aimed to investigate the effects of sociodemographic parameters on healthy and sustainable nutrition in nutrition students. This cross-sectional study was conducted with 601 students. Researchers administered questionnaire forms to gather sociodemographic information such as age, gender, geographical region, residence area, accommodation, BMI, and income level. Participants’ 24 h dietary records were used to evaluate Healthy Eating Index-2020 (HEI-2020) and Planetary Health Diet Index (PHDI). The mean PHDI scores of the Marmara (53.4 ± 14.9), Aegean (58.2 ± 18.3), Mediterranean (55.3 ± 15.5), and Black Sea (55.5 ± 15.7) regions, which are the coastal regions of Türkiye, were significantly higher than for the Central Anatolia region (46.7 ± 15.1). The PHDI and HEI-2020 score means of students living in metropolitan cities and rural areas were significantly higher than those living in urban areas (p < 0.05). Being in the 20–25 years age group increased the probability of being in a lower PHDI group (AOR 1.82; 95% CI 1.07:3.12; p = 0.028). While a similar result was found in the 20–25 years age group for HEI-2020, income level and gender did not have a statistically significant effect on these scores. Since students’ ages, geographical regions, and residence areas affect PHDI and HEI-2020, it is considered important to take these sociodemographic variables into consideration in guidelines and studies. Full article