Search Results (848)

Background: University students often report suboptimal dietary practices, but overall diet-quality scores may conceal differences in food-group consumption. This study explored whether distinguishable food-consumption profiles could be identified among university students from Chile, Mexico, Spain, and Italy, and examined, exploratorily, the characteristics associated with profile membership. Methods: In this cross-sectional study, 686 university students completed a dietary assessment using nine component scores of the Healthy Eating Index adapted for the Spanish population (IASE). Profiles were derived by Ward’s hierarchical clustering with k-means refinement and assessed for split-half stability; Exhaustive CHAID explored characteristics associated with profile membership. Results: Internal validity indices favoured no candidate solution (silhouette 0.113–0.126 across two- to five-cluster solutions), and split-half stability was limited throughout, including for the retained four-cluster solution (mean Adjusted Rand Index = 0.30). Four profiles were nonetheless retained: Healthy and Prudent (24.8%), Low Plant-Food (13.0%), Mixed Dietary (36.6%), and Protein-Oriented (25.7%); all occurred in every country. Country was the first CHAID split, followed by living arrangement (Chile/Mexico), year of study (Spain), and post-pandemic PA change (Italy). The model did not outperform the majority-class baseline; the segmentation is therefore exploratory, not predictive. Conclusions: A four-cluster configuration could be derived in each setting, but validity and stability indices indicate it is not robust; country/academic-programme—confounded with institution—was the only characteristic with a non-negligible, though modest, association with profile membership. Findings are hypothesis-generating and require replication in larger, representative, longitudinal samples before profiles are treated as an established typology. Full article

Background/Objectives: Diet quality among Mexican-born immigrant women may be influenced by food security (FS) and neighborhood food environment factors; however, these relationships remain understudied. This exploratory study examined differences in diet quality/dietary outcomes by FS status and explored the potential for perceived neighborhood food availability to modify the association between FS and diet quality. Methods: Mexican-born immigrant women (n = 57) self-reported FS, diet, and perceived neighborhood food availability. Diet was assessed using the Southwest Food Frequency Questionnaire to calculate the Healthy Eating Index (HEI-2020) score. The six-item USDA FS Scale was used to dichotomize FS as high or low. Independent t-tests assessed differences in HEI-2020; fast-food frequency; and intake of fruit, vegetables, salty snacks, and sugar by FS status. An exploratory regression analysis examined whether perceived food availability modified the association between FS and diet quality using complementary Bayesian techniques to improve efficiency given the small sample size. Results: Women experiencing low FS had lower HEI-2020 than those with high FS (62 ± 8 vs. 66 ± 6; p = 0.03), as well as non-significantly lower intakes of fruit (236 ± 178 vs. 294 ± 239 g), vegetables (303 ± 188 vs. 331 ± 199 g), and salty snacks (6 ± 5 vs. 8 ± 10 g) and higher intakes of sugar (99 ± 55 vs. 96 ± 56 g) and fast food (2.5 ± 2.5 vs. 1.8 ± 1.7 times/month). No statistically significant evidence of the perceived neighborhood food availability modifying the association between FS and diet quality was observed. Exploratory analysis suggested that among women experiencing low FS, HEI-2020 score varied by perceived neighborhood food availability (low: 57; moderate: 61; high: 65; p = 0.077). Bayesian analyses suggested a greater impact of perceived neighborhood food availability among women with low FS and lower diet quality. Conclusions: In this small sample of Mexican-born women, low FS was associated with lower diet quality. Although evidence of effect modification by perceived neighborhood food availability was not observed, exploratory findings suggest that it may influence diet quality among women experiencing low FS and warrant investigation in larger studies. Full article

Background: Academic pressure during examination periods is frequently reported alongside irregular lifestyle behaviors. The study aimed to explore the interplay between habitual eating behaviors, sleep quality, and self-reported stimulant use and coping adaptations specifically during examination periods among healthcare university students. Methods: This cross-sectional study included 265 university students (Mage = 22.00, SD = 4.46). Dietary behaviors and sleep quality were assessed using the Three-Factor Eating Questionnaire (TFEQ-R21) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Behavioral profiles, substance-use patterns, and attitudes toward academic pressure were examined using bivariate analyses, multivariate logistic regression, and TwoStep cluster analysis. Statistical analyses were performed using IBM SPSS Statistics version 26.0. Results: A high prevalence of poor sleep quality was observed, with 72.8% (n = 193) of participants meeting the clinical criterion for poor sleep (PSQI > 5.0; M = 7.79 ± 3.53), and high sleep disturbances were significantly associated with smoking, energy drink use, coffee escalation, general dietary supplement utilization, and smart-drug use. Multivariate analysis revealed that poor sleep quality (OR = 1.118, 95% CI [1.022, 1.222]) and younger age (OR = 0.843, 95% CI [0.735, 0.967]) were independently associated with higher odds of energy drink use. A distinct cognitive disconnect was observed in tobacco usage: conventional smoking was negatively associated with self-perceived health (OR = 0.401, 95% CI [0.182, 0.884]), whereas electronic cigarette use showed no significant association. TwoStep cluster analysis identified three distinct student typologies during exams: non-users (32.6%), poly-substance users (34.5%), and OTC supplement/caffeine users (33.0%), with active substance-utilizing profiles displaying significantly worse sleep quality and higher emotional eating. Conclusions: These findings highlight distinct cross-sectional lifestyle and coping patterns among healthcare students, emphasizing the need for targeted institutional interventions that support healthy behavioral adaptations and stress management during academic challenges. Full article

Background: Rural Appalachian communities experience high rates of food insecurity, poor diet quality, and chronic disease. Community-based participatory research (CBPR) and policy, systems, and environmental (PSE) approaches may improve nutrition-related outcomes through locally tailored interventions. This study evaluated the impact of Laurel HARVEST (Helping Appalachia Restore a Vibrant Food Environment for Self-Sufficiency, Together) on dietary quality and food security in Appalachian Kentucky. Methods: A prospective cohort study was conducted in Laurel County, Kentucky (intervention) and Pike County, Kentucky (comparison). Adults aged ≥18 years were recruited at baseline (2022–2023) and followed through 2025. CBPR-guided interventions included nutrition education, recipe card dissemination, raised bed gardens, and community mini-grants. Outcomes included Healthy Eating Index (HEI) scores derived from 24 h dietary recalls, dermal carotenoid concentrations measured using the Veggie Meter^®, and food security assessed with the USDA 10-item Household Food Security Module. Results: A total of 282 participants were enrolled at baseline (Laurel n = 121; Pike n = 161), and 147 completed follow-up assessments. Dermal carotenoid scores increased significantly more in Laurel County (37.3 points) than in Pike County (13.3 points) (p = 0.032). No significant between-county differences were observed for total HEI score or food security. Conclusions: CBPR-driven, multilevel interventions were associated with modest improvements in fruit and vegetable intake but did not significantly improve overall dietary quality or food security. Longer-term structural and policy-level approaches may be needed to address nutrition and food access challenges in rural Appalachian communities. Full article

Background: Research on family support has primarily focused on emotional aspects, paying less attention to instrumental support and its concurrent association with food-related well-being. Aim: To explore direct and indirect actor and partner effects among parents’ instrumental family support, diet quality, and satisfaction with food-related life (SWFoL) in dual-earner families with adolescents. Methods: Online surveys were conducted with 860 dual-earner parent dyads and one adolescent child (mean age 12.7 ± 1.8 years; 49.8% female) in Chile. Family members completed the Adapted Healthy Eating Index and the SWFoL Scale; parents also answered an Instrumental Support subscale. Analyses were conducted using a mediation Actor–Partner Interdependence Model via structural equation modeling. Results: Mothers’ and fathers’ instrumental support was positively associated with their own SWFoL, both directly and indirectly via their diet quality. Parents’ support was also positively related to adolescents’ SWFoL directly and indirectly via adolescents’ diet quality. Symmetrical crossover effects between instrumental support and SWFoL emerged for both parents. Mothers’ support was additionally associated with fathers’ SWFoL indirectly through fathers’ diet quality. Conclusions: Instrumental support operates as a vital systemic resource within dual-earner households. By enhancing diet quality, tangible support protects family food-related well-being and embeds adolescents’ nutritional health within the parental resource ecosystem. Full article

Background/Objectives: There is continuing debate regarding the association between added sugars (AS) consumption and overall diet quality, which remains a research gap within the Canadian population. This study aimed to assess the association between intakes of added sugars and the Healthy Eating Food Index (HEFI) 2019 that measures adherence to Canada’s Food Guide as an indicator of diet quality. Methods: The first 24 h dietary recalls of Canadians 2 years and older (n = 19,532) from the 2015 Canadian Community Health Survey—Nutrition were used. Added sugars intakes were calculated based on a systematic 10-step algorithm. Descriptive statistics were obtained for total HEFI and component scores across different AS intake categories. The association between AS categories and HEFI scores was tested using a generalized linear model adjusted for age, sex, education level, type of smoker, and misreporting status. Results: The association between continuous AS intake and HEFI scores was non-linear. In the categorical model, AS intake categories were inversely associated with HEFI scores among Canadians (R² = 0.32, p < 0.001). Large overlaps in HEFI scores were observed among individuals with similar AS intakes for the whole population and each age group. Among high AS consumers (>15% EI), lower HEFI scores were largely due to higher proportions of sweetened beverages (i.e., low beverage scores) and lower intakes of vegetables and fruit and plant-based proteins. Scores for protein food and whole grains were low across all AS intake categories. Conclusions: Large variations in overall HEFI scores were observed amongst those with similar AS intakes, suggesting that added sugars alone may not fully capture overall diet quality or adherence to Canada’s Food Guide. Full article

This study explores the behavioral intersection of nutritional health and environmental literacy among pre-service teachers within the national higher education context. Utilizing the Sustainable Healthy Diet Index (SHED Index) for the first time in Croatia, this research systematically examines the dietary habits, lifestyle choices, and socio-cultural patterns of future educators (N = 164) at the University of Split. The survey instrument evaluated the core SHED domains, Healthy Eating (HE) and Sustainable Eating (SE), alongside supplementary indicators monitoring food logistics, hydration, and waste management. Descriptive analysis revealed moderately high standardized overall SHED scores (M = 62.86), aligning with the original normative distribution. Notably, students achieved significantly higher descriptive sub-scores in the HE domain (M = 24.68) than in the SE domain (M = 18.06). Although domestic food consumption and circular recycling practices were well integrated, critical biospheric behaviors—such as reducing animal protein, consuming legumes, purchasing organic food, and composting—remain limited by cultural resistance and municipal infrastructure deficits. Furthermore, an independent t-test indicated no significant differentiation across study levels, highlighting a potential institutional stagnation throughout the five-year teacher education program. Regression analysis demonstrated that sustainable dietary choices appear to be strongly anchored in personal health concerns rather than biospheric altruism, with healthy eating emerging as the single strongest explanatory factor for of sustainable behavior. These findings indicate that to cultivate authentic ecological literacy in the future teaching workforce, higher education curricula require a systemic redesign that explicitly links sustainability to personal well-being through localized, experiential learning. Full article

The aim of this study is to investigate how external nutrient supply affects the allocation of reproductive energy during artificial ripening of American eels (Anguilla rostrata), as well as the physiological regulatory mechanisms involved in their bodies. Healthy female American eels were selected for the experiment and randomly divided into two groups: feeding group and starvation group (simulating the natural migration of American eels without eating). The initial weight of the feeding group was (308.43 ± 36.99 g), and the initial weight of the starvation group was (291.67 ± 63.31 g). The entire experiment was divided into two stages: the first stage was a 6-month nutritional reinforcement period, during which the feeding group was regularly fed with Vannamei shrimp, while the starvation group was not fed throughout the entire process. The second stage was a 3-month artificial ripening stage, during which both groups of eels stopped feeding. Inject 1 mL of mixed hormone (containing 6.5 mg of carp pituitary extract CPE+200 IU human chorionic gonadotropin HCG per mL per week) into each eel for a total of 12 injections to induce gonadal maturation. Both groups of eels did not die during the experiment, with a survival rate of 100%. As the gonads continue to develop and mature, the growth and development advantages of the feeding group of eels are very obvious: body weight, chest circumference, and gonadal index are significantly higher than those of the starvation group. After completing 12 hormone injections, the gonadal index of the feeding group reached (32.72 ± 7.01%), while that of the starvation group was only (4.35 ± 2.48%). Under artificial ripening conditions, the egg diameter of the feeding-eel group increased rapidly in the later stage of the experiment. The growth rate of eggs in the starvation group was slow, and the final egg diameter was significantly smaller. The diameters of the nuclei of both groups of oocytes increased synchronously with the progress of the experiment; the number of nucleoli in the feeding group first increased and then decreased, while the number of nucleoli in the starvation group continued to increase. The oil droplets inside both sets of eggs gradually increased in size, and the oil droplets fed to the eggs in the middle and late stages of maturation had a larger volume. Hormone test results showed that the testosterone (T) level in the eel fed group increased significantly in the later stage of the experiment. This indicates that adequate nutrition can alleviate the inhibition of the reproductive endocrine axis through positive feedback regulation of the pituitary gonad (BPG) axis. Nutritional reinforcement before ripening can promote gonadal development and enhance reproductive capacity by regulating the distribution of nutrients between muscles and gonads. The results of this study provide a solid theoretical basis for improving the nutritional management plan for parent fish in the fully artificial breeding process of American eels. Full article

Background: Assessing overall diet quality has become increasingly important in nutritional epidemiology. The Healthy Eating Index (HEI) is one of the most widely used measures of diet quality; however, comparable data on Hungarian children are scarce. The current study aimed to assess the diet quality of Hungarian children using the Healthy Eating Index and to examine demographic factors associated with diet quality. Methods: This cross-sectional study included 666 children aged 4–10 years. Dietary intake was measured using three-day dietary records, and sociodemographic factors were collected via parental questionnaires. Diet quality was assessed using the Healthy Eating Index-2020 (HEI-2020). For the statistical analysis, linear regression, random forest models and one-way ANOVA with Tukey’s post hoc test were used. Results: The mean HEI score was 48.2 (SD 8.02), indicating low diet quality. Settlement type was significantly associated with the HEI score (p = 0.009). The multiplicity-corrected p-values for pairwise comparisons showed that children living in towns had significantly lower HEI scores (44.9, SD 7.97) than those living in county capitals (3.9, 95% CI:0.8–7.0, p = 0.006) and villages (−3.6, 95% CI: −0.61–−6.6, p = 0.011), but not significantly lower than those living in the capital (3.09, 95% CI: −0.25–6.4, p = 0.08). These differences were primarily related to whole-fruit and whole-grain component scores. Sex, age, and maternal education were not significantly associated with HEI score. The random forest model showed weak predictive performance (RMSE = 7.66). Conclusions: Diet quality among Hungarian children was generally suboptimal. The examined sociodemographic characteristics accounted for only a small proportion of the variability in the HEI score. This highlights the importance of ongoing research to understand dietary patterns and to uncover additional social, environmental, and behavioral aspects of dietary habits across cultures. Furthermore, the results indicate that interventions should also consider local food environments. Full article

Background: Adolescence is a sensitive period during which sleep undergoes substantial change, increasing vulnerability to sleep disturbances and their health consequences. Psychological inflexibility (PI) and experiential avoidance (EA), operationalized through the Acceptance and Action Questionnaire-II (AAQ-II), have been associated with poorer sleep among adults; however, evidence in adolescents remains scarce. This study examined the association between PI, EA, and sleep-related problems in a representative sample of Spanish adolescents. Methods: A cross-sectional analysis was conducted using data from 623 adolescents (aged 12–17 years; 56.7% girls) from the Eating Healthy and Daily Life Activities (EHDLA) study, conducted in the Valle de Ricote (Murcia, Spain) during 2021–2022. PI and EA were assessed with the Spanish-validated AAQ-II; sleep-related problems were screened using the BEARS (B = Bedtime problems, E = Excessive daytime sleepiness, A = Awakenings during the night, R = Regularity and duration of sleep, S = Snoring) questionnaire across five domains. Generalized linear models were adjusted for sex, age, socioeconomic status, physical activity, sedentary behavior, body mass index (BMI) z-score, energy intake, and sleep duration. Results: Higher AAQ-II scores were significantly associated with increased probabilities of bedtime problems (+0.9% per point; 95% confidence interval [CI]: 0.6–1.1%), excessive daytime sleepiness (+1.0%; 95% CI: 0.7–1.2%), nocturnal awakenings (+0.7%; 95% CI: 0.5–1.0%), and problems with sleep regularity and duration (+0.8%; 95% CI: 0.5–1.1%). Each additional AAQ-II point increased the probability of reporting any sleep-related problem by 1.2% (95% CI: 0.9–1.5%; p < 0.001). Corresponding adjusted odds ratios ranged from 1.04 to 1.06 per point. No significant association was found for snoring. Conclusions: In this cross-sectional study, psychological inflexibility and experiential avoidance were positively associated with several sleep-related problems among adolescents. Longitudinal and intervention studies are warranted before causal or clinical recommendations can be made. Full article

Background/Objectives: This study aimed to examine whether regular exercise and healthy nutrition behaviors are associated with subjective well-being at school among adolescents. Methods: This descriptive study was conducted with 272 high school students aged 15–18 years who participated on a voluntary basis. Data were collected using the Nutrition and Exercise Behavior Scale, the Subjective Well-Being at School Scale, and a demographic information form. Descriptive statistics, group comparisons, correlation analyses, and regression analyses were performed to evaluate the relationships between lifestyle behaviors and subjective well-being at school. Results: The mean age of the participants was 16.27 ± 0.88 years; 55.9% were female and 44.1% were male. According to Body Mass Index (BMI) classification, 15.4% were underweight, 62.9% were normal weight, 16.2% were overweight, and 5.5% were obese. No statistically significant differences were found in subjective well-being at school scores according to gender or BMI categories (p > 0.05). Regression analysis indicated that healthy nutrition and exercise behaviors were positively associated with subjective well-being at school (β = 0.380, p < 0.001), whereas psychological/dependent eating behaviors were negatively associated with subjective well-being at school (β = −0.171, p = 0.043). Conclusions: Healthy nutrition and exercise behaviors were significantly associated with subjective well-being at school among adolescents. School-based lifestyle interventions may help support adolescents’ well-being at school and may inform future health promotion strategies. Full article

Background/Objectives: Diet quality is relevant to athlete health and recovery, yet practical methods for assessing dietary patterns in elite sporting environments remain limited. This exploratory study aimed to examine the relationship between skin carotenoid status and diet quality in male professional National Rugby League players. Methods: Skin carotenoids were assessed at three time points throughout the NRL season: pre-, mid-, and end-season. The Veggie Meter^® was used to assess carotenoids alongside a single 24 h dietary recall at each time point. Dietary data for each player were scored using the Healthy Eating Index for Australian Adults 2013 (HEIFA-2013) to calculate a score out of 100. Correlations were explored via Pearson correlation coefficients, and linear mixed models were used to compare data over the season. Results: Correlations between carotenoid status and diet quality score varied across time points: pre-season, r = 0.297, 95% CI −0.094 to 0.608, p = 0.196; mid-season, r = 0.451, 95% CI 0.108 to 0.698, p = 0.012; and end-season, r = 0.335, 95% CI −0.036 to 0.625, p = 0.076. Mean carotenoid scores did not differ significantly across the season: 294 in pre-season (n = 27), 314 in mid-season (n = 30), and 318 in end-season (n = 29), p = 0.16. Mean HEIFA-2013 scores also did not differ significantly across the season: 66.4 in pre-season, 64.6 in mid-season, and 62.6 in end-season, p = 0.38. Conclusions: This exploratory study provides preliminary evidence that skin carotenoid status may reflect aspects of diet quality in elite NRL players, although associations varied across time points and only reached statistical significance at mid-season. Non-invasive tools such as the Veggie Meter^® may complement traditional dietary assessment methods, although further validation is required in larger, adequately powered studies of elite athletes. Full article

Background/Objectives: Nutrition during childhood and adolescence is a key determinant of long-term health, influencing metabolic homeostasis, neurocognitive development, and immune system maturation. Globalization and technological advances have reshaped food production and consumption, increasing the availability of ultra-processed foods (UPF) of low nutritional quality. This study aimed to investigate the relationship between parental factors, namely food literacy, perceived barriers and enablers, dietary attitudes, and healthy eating behaviors, and the consumption of discretionary UPF among children and adolescents living in 5 Mediterranean countries. Methods: This cross-sectional study was based on a survey completed by 2011 parents of children and adolescents aged 6–17 years from 5 Mediterranean countries, who reported on their children’s dietary and lifestyle habits. Adherence to the Mediterranean diet was assessed through the KIDMED index. Parental food literacy was measured using the Short Food Literacy Questionnaire (SFLQ). Perceived barriers and enablers were assessed based on the Theory of Planned Behavior, and parents’ attitudes toward their child’s diet were evaluated using the Healthy-Eating Attitudes Questionnaire (HEAQ). Finally, the Theory of Internet Use Related to Health (TIUH) questionnaire was used to assess parents’ tendencies related to health information use online. Results: Higher perceived barriers and enablers were significantly associated with lower discretionary UPF consumption across all models. Parental food literacy (SFLQ) showed a positive association with discretionary UPF consumption, remaining significant in the fully adjusted model, although with reduced magnitude. Healthy-eating attitudes (HEAQ) were initially positively associated with discretionary UPF intake but lost statistical significance after full adjustment. Regarding health-related internet use (TIUH), the Health Information dimension showed a strong positive association with discretionary UPF consumption, while other dimensions (Consciousness and Beliefs) showed inconsistent and non-significant associations in the fully adjusted model. Conclusions: Children’s consumption of discretionary UPF is shaped by several interrelated factors, such as family environment, eating patterns, and parents’ perceptions, rather than solely by knowledge or attitudes. Full article

Background: We previously reported that consuming a Mediterranean-style healthy dietary pattern (MED-HDP) with lower vs. higher glycemic index foods differentially changed indices of postprandial glucose control and daily glycemic variability but did not influence improvements in cardiovascular health indices. Methods: Fifty-two adults (31 females, 21 males; aged 49 ± 11 y, BMI 31 ± 3.1 kg/m², mean ± SD) with two or more features of metabolic syndrome participated for 12 weeks in the randomized, controlled trial with all foods provided. At dinner only, participants could select from protocol-approved foods, including unprocessed chicken breast, unprocessed lean beef, and unprocessed salmon and shrimp (seafood). Objective: Herein, we retrospectively assessed whether the frequency of consuming different sources of meat (i.e., the exposures) was associated with MED-HDP-induced changes in cardiovascular health indices (i.e., the outcomes). Results: Among all participants, consuming the MED-HDP foods (88% adherence) reduced fasting systolic (SBP) and diastolic (DBP) blood pressures and serum total cholesterol (TC), triglycerides (TGs), and HDL. More frequent consumption of chicken at dinner, in place of beef and seafood, was associated with greater reductions in SBP (p = 0.034 and p = 0.047 for replacing beef and seafood, respectively) and DBP (p = 0.021 and p = 0.043, respectively). Frequency of chicken, beef, and seafood intakes at dinner did not associate with the reductions in serum TC, TG, HDL, or LDL. Conclusions: These results support that adoption of a MED-HDP improved multiple cardiovascular risk factors among middle-aged and older adults at elevated cardiovascular risk. The observed modest associations between more frequent consumption of unprocessed chicken at dinner and greater blood pressure reductions, which do not mean that eating more chicken at dinner causes lower blood pressure, warrant independent replication. Full article

Background: Population ageing increases the burden of chronic diseases, multimorbidity, and functional limitations, making nutrition and lifestyle important modifiable determinants of healthy ageing. Universities of the Third Age (U3A) provide an educational and social environment for older adults, but multidimensional relationships between nutrition knowledge, diet quality, lifestyle, and health status in this population remain insufficiently characterized. This study aimed to assess these associations among older adults attending U3A in Poland. Methodology: A cross-sectional online survey was conducted between January and April 2026 among community-dwelling older adults participating in U3A programs. Of 700 distributed invitations and 520 returned questionnaires, 450 complete and eligible responses were included. The questionnaire was based on the KomPAN^® framework and expanded with items on health, lifestyle, psychosocial resources, barriers to healthy eating, and sources of health information. Diet quality was assessed using the pro-Healthy Diet Index, non-Healthy Diet Index, and overall Diet Quality Index (DQI). Nutrition knowledge was measured using a 24-item scale. Analyses included distributional diagnostics, non-parametric group comparisons, FDR-corrected Spearman correlations, psychometric assessment, principal component analysis, multivariable regression with model diagnostics, and profile segmentation. Results: The mean age was 73.63 ± 5.73 years, and most participants were women. The median DQI was 15.59 [3.93–24.86], with a predominance of neutral diet quality. Nutrition knowledge was moderate, with a median score of 12.00 [9.00–15.00], and the scale showed very good internal consistency. PCA identified three dietary patterns: convenience/ultra-processed, prudent/health-promoting, and traditional meat-and-fat. Higher DQI was associated with better nutrition knowledge, greater physical activity, a more favorable sleep profile, regular meal timing, and lower disease burden. Participants with multimorbidity had significantly lower DQI. Segmentation distinguished a health-engaged/higher-resource profile and a lower-resource/nutritionally vulnerable profile. Conclusions: U3A participants in Poland are educationally and socially active but nutritionally heterogeneous. The predominance of neutral diet quality, moderate nutrition knowledge, and identifiable knowledge gaps indicates the need for targeted, practical, and behavior-oriented nutrition education supporting healthy ageing. Full article