Search Results (141)

Background/Objectives: Breast cancer is the most common malignancy among women globally, with survival rates improving due to earlier detection and better treatment. As a result, cancer survivors now constitute a growing segment of the population, and addressing their long-term health and well-being is a public health priority. Diet and nutrition represent modifiable factors that may influence recurrence, comorbidities, and quality of life (QoL), yet clear evidence-based guidance remains limited. This umbrella review thus synthesized evidence from published reviews on the effects of dietary and nutrition interventions among breast cancer survivors. Methods: Following a prospectively registered protocol in PROSPERO (CRD420251185022), six databases (PubMed, EMBASE, Scopus, Cochrane Library, PsycINFO and CINAHL) were systematically searched for systematic reviews/meta-analyses evaluating dietary or nutrition interventions in adult breast cancer survivors. Eligible reviews reported anthropometric, metabolic, psychosocial, or survival outcomes. Methodological quality was appraised using the AMSTAR-2 tool, and findings were narratively synthesized. Results: Nine systematic reviews encompassing more than 10,000 breast cancer survivors were included. Interventions ranged from general dietary counselling and structured weight-management programmes to Mediterranean-style dietary patterns, dietitian-led primary care, multiple health behaviour change interventions, mobile nutrition apps, and broader lifestyle programmes incorporating diet. Across reviews, interventions consistently improved diet quality and fruit–vegetable intake, produced modest but meaningful reductions in weight, body mass index, and body fat, and enhanced several QoL domains (e.g., fatigue, physical functioning, body image). Higher adherence to Mediterranean-style diets was associated with lower all-cause and non–breast cancer mortality, though certainty was limited by observational designs. However, evidence for long-term maintenance, survival endpoints, and ethnically diverse or low- and middle-income populations remains sparse. Conclusions: Dietary and nutrition interventions, particularly structured, dietitian-supported, and Mediterranean-style approaches, contribute to improved diet quality, sustainable weight control, and enhanced QoL among breast cancer survivors. Integrating nutrition care into survivorship pathways should be the focus of future research. Full article

This study investigated the interrelationships among Lifestyles of Health and Sustainability (LOHASs), recreational benefits, and environmentally responsible behaviors (ERBs) of visitors to the Xitou Forest Recreation Area in Taiwan and estimated the conservation value of its forest recreation resources using the contingent valuation method. The structural equation modeling analysis supported six of eight hypotheses. Three LOHAS factors (environmental awareness, internal health, and external health) indirectly promoted ERB through recreational benefits, including environmental education, psychological, physiological, and social benefits. Higher income, stronger perceived recreational benefits, and recognition of ecological or facility value significantly increased visitors’ willingness to pay (WTP). Among the three identified lifestyle clusters, the health-conscious LOHAS group consistently exhibited the highest WTP at NTD$263, with a confidence interval of NTD$255–271, surpassing both the eco-friendly group (NTD$193–209) and socially engaged group (NTD$184–200), demonstrating a stronger commitment to ecological and environmental protection and recreational facility maintenance. Forest recreation managers can target different LOHAS segments and emphasize the holistic benefits of forest recreation. Implementing flexible pricing alongside environmental education can increase WTP, supporting sustainable conservation funding and improved visitor experiences. Full article

The Mediterranean Diet (MD) is a lifestyle that involves not only dietary habits, well known for their effectiveness in preventing health risks by supplying well-balanced foods rich in bioactive compounds, but also daily habits that improve the quality of life. Older adults represent a segment of the population that can particularly benefit from this dietary pattern. However, the specific characteristics and needs of older individuals require a critical analysis of aspects that may limit adherence to the MD principles, including physical impairments related to eating, sensory and cultural aspects, accessibility of food sources, and the social context. The objective of this study was to review the potential benefits of the MD in relation to the needs, capacities and eating behaviors of older adults, focusing on the beneficial effects of plant-based food metabolites and their suitability for older adult diets. The results demonstrate how the MD can be tailored to meet the nutritional and functional needs of older adults, supporting healthy aging. Therefore, the Mediterranean lifestyle could be an effective tool in public health policies to promote healthy habits, thereby improving the quality of life in vulnerable population categories. Full article

Background: University students often display unhealthy eating habits shaped by economic, cultural, and psychosocial factors. These behaviors increase risks of chronic and mental disorders. The COVID-19 pandemic further changed their diet and physical activity (PA) habits, highlighting the need to identify determinants of diet quality (DQ). Objective: The objective of this study is to identify risk profiles of poor DQ among university students from Chile, Mexico, Spain, and Italy through multivariate segmentation analysis. Methods: A cross-sectional predictive study was conducted among 686 university students (60.8% women; mean age = 22.4 ± 5.1 years) using an online questionnaire on sociodemographic, academic, health, and lifestyle factors, including PA (IPAQ-SF^®) and DQ (HEI). Analyses included descriptive, inferential, and decision tree (CHAID and CART) models. Results: Significant differences in HEI scores (p < 0.001) were observed by country, field of study, academic year, and PA level. Chilean and Mexican students had the lowest DQ. Both models achieved high overall accuracy (≈91%), but balanced accuracy was around 50%, reflecting limited discrimination of healthy diet profiles and underscoring their exploratory value for identifying at-risk subgroups rather than precise prediction. CART identified country of residence and socioeconomic status as the primary determinants of poor diet quality (DQ), while CHAID highlighted field of study and socioeconomic status, with PA and BMI contributing at secondary levels. Conclusions: The results emphasize adapting public health strategies to local contexts—promoting Mediterranean-style diets in European universities and improving access to affordable healthy foods in Latin American campuses, complemented by campus initiatives integrating nutrition education, physical activity, and psychosocial support. Full article

Background/Objectives: Interest in alternatives to animal-derived products has gained momentum, driven by health, environmental, and ethical concerns. However, consumer interest in plant-based meat alternatives (PBMAs) remains highly heterogeneous. This study employs the core dimensions of the Food-Related Lifestyle (FRL) framework for consumer segmentation to deepen understanding of PBMA adoption in a meat-centric context such as Poland, and to derive segment-specific recommendations that support the transition toward plant-based diets. Methods: A cross-sectional survey was conducted among a representative sample of Polish adults (n = 1200). Consumer segmentation was performed using a two-step cluster analysis based on the three FRL dimensions—food involvement, innovativeness, and responsibility. Results: Four distinct consumer clusters emerged, differing significantly across all FRL dimensions (p < 0.001). Cluster 1, Traditionalists (18.5%), demonstrated high food involvement but the lowest innovativeness, showing the highest proportion of non-buyers and strong environmental scepticism. Cluster 2, Conscious Food Enthusiasts (24.6%), demonstrated the highest scores across all FRL dimensions, reported the most frequent PBMA purchases, and showed a strong sustainability orientation combined with a pronounced appreciation for sensory quality and eating enjoyment. Cluster 3, Moderates (38.8%) occupied intermediate positions exhibiting moderate PBMA purchasing frequency but expressing concern about food waste. Cluster 4, Careless Food Lovers (18.2%, n = 218), showed high food involvement and innovativeness, but the lowest responsibility, characterised by pronounced environmental scepticism. Conclusions: The study shows that consumer segments with similar levels of food involvement differ in their perceptions, beliefs, and willingness to adopt PBMAs, primarily according to their environmental orientation. These findings highlight that a strong interest in food alone does not translate into acceptance of plant-based alternatives unless accompanied by sustainability-oriented values. Overall, the results offer practical guidance for designing marketing, product development, and policy initiatives tailored to distinct consumer profiles, supporting the transition toward more plant-based dietary patterns. Full article

This study examines hiking within the context of active lifestyle trends, with a particular focus on the implications of physical limitations for its implementation in forest environments. The primary objective is to analyze how hiking offerings can be adapted to account for varying physical constraints that influence the selection and accessibility of forest landscapes. Special emphasis is placed on the intersection of forest-based recreation and geotourism, as both natural settings provide not only opportunities for physical activity but also unique geological and ecological values that shape visitor experience. The research emphasizes the role of physical fitness as a key factor in segmenting hiking participants, introducing it as a measurable parameter for categorization. To achieve this, the study applies quantitative methods, including motor ability tests, physical fitness assessments, somatic measurements, and verification of tourist categorization. Statistical analyses employed include descriptive statistics of performance values, two-sample t-tests, and Pearson’s correlation coefficients. The framework for designing hiking experiences highlights the importance of integrating forest trails and geotourism sites into accessible tourism planning. This approach demonstrates the potential benefits of incorporating physical fitness considerations into hiking development, ultimately enhancing accessibility, inclusivity, and safety in forest and environments. Full article

Upcycled foods are a rising trend as the issue of food waste and sustainability becomes an increasing concern. The objective of this research was to evaluate the perception of upcycled foods through the characterization of consumer segments. An online questionnaire was developed to evaluate food neophobia, lifestyle, behavior, beliefs, awareness, and familiarity or recognition of upcycled and sustainable food products using a pre- and post-infographic intervention. The survey was created using Red Jade SaaS and distributed to participants through the Cal Poly Sensory database, North Carolina State University Sensory Service Center database, social media (LinkedIn and Nextdoor), and personal communication. Participants (n = 947) were segmented using a k-means clustering algorithm on lifestyle, neophobia, and beliefs questions. Four clusters were identified: Greenthusiasts (n = 306)—environmentally conscious and open-minded to new products, Balanced Believers (n = 347)—supportive of new products with reasonable doubt, Healthy Hesitants (n = 208)—willing to make health-focused changes but hesitant towards new products and technologies, and Eco-Skeptics (n = 86)—doubtful and resistant to change, most food and technologically neophobic. Based on pre- and post-intervention, Eco-Skeptics had the lowest initial awareness and recognition of sustainable and upcycled food products, while Greenthusiasts had the highest. All four segments trended towards improved recognition of the food products post-intervention. Full article

This study examines how psycholinguistic features of online reviews relate to guest satisfaction in Bali’s spa hotel market. Using LIWC-22 category rates from Google Maps reviews, a corpus of 15,560 quality-filtered reviews from ten leading spa hotels was analyzed. Exploratory factor analysis yielded four interpretable dimensions—Social, Health and Wellness, Emotional Tone, and Lifestyle. In regressions predicting review star ratings (satisfaction), Social (β = 0.028) and Health and Wellness (β = 0.023) showed small but statistically detectable positive associations, whereas Emotional Tone (β = 0.006, t = 0.727) and Lifestyle (β = 0.004, t = 0.476) were not significant. The model’s explained variance is negligible (R² = 0.001; F = 5.283, p < 0.05), reflecting the many influences on ratings beyond review language; findings are interpreted as directional associations rather than predictive effects. Practically, the results point to prioritizing interpersonal service cues and wellness/treatment assurances, with tone monitoring being used for service-recovery signals. The design favors interpretability (validated, word-based categories; full-history snapshot) over black-box complexity, and transferability is Bali-specific and conditional on comparable market features. Future work should add contextual covariates (e.g., price and location), apply explicit temporal segmentation, extend to multilingual corpora, and triangulate text analytics with brief questionnaires and qualitative inquiry to strengthen validity and explanatory power. Full article

The introduction of mobile banking is essential in today’s financial sector, where technological innovation plays a critical role. To remain competitive in the current market, businesses must analyze client attitudes and perspectives, as these influence long-term demand and overall profitability. While previous studies have explored general adoption behaviors, limited research has examined how individual factors such as social influence, lifestyle compatibility, financial technology self-efficacy, and perceived usage cost affect mobile banking adoption among specific generational cohorts. This study addresses that gap by offering insights into these variables, contributing to the growing literature on mobile banking adoption, and presenting actionable recommendations for financial institutions targeting younger market segments. Using a structured questionnaire survey, data were collected from both users and non-users of mobile banking among the Gen Z population in the United States. The regression model significantly predicts mobile banking adoption, with an intercept of $-0.548$ ($p < 0.001$). Among the independent variables, perceived cost of usage has the strongest positive effect on adoption ($B=0.857$, $\beta =0.722$, $p < 0.001$), suggesting that adoption increases when mobile banking is perceived as more affordable. Social influence also has a significant positive impact ($B=0.642$, $\beta =0.643$, $p < 0.001$), indicating that peer influence is a central driver of adoption decisions. However, self-efficacy shows a significant negative relationship ($B=-0.343$, $\beta =-0.339$, $p < 0.001$), and lifestyle compatibility was found to be statistically insignificant ($p=0.615$). These findings suggest that reducing perceived costs, through lower fees, data bundling, or clearer communication about affordability, can directly enhance adoption among Gen Z consumers. Furthermore, leveraging peer influence via referral rewards, Partnerships with influencers, and in-app social features can increase user adoption. Since digital self-efficacy presents a barrier for some, banks should prioritize simplifying user interfaces and offering guided assistance, such as tutorials or chat-based support. Future research may employ longitudinal designs or analyze real-life transaction data for a more objective understanding of behavior. Additional variables like trust, perceived risk, and regulatory policies, not included in this study, should be integrated into future models to offer a more comprehensive analysis. Full article

High-quality green gardens can markedly enhance the quality of life and mental well-being of their users. However, health and lifestyle constraints make it difficult for people to enjoy urban gardens, and traditional methods struggle to offer the high-fidelity experiences they need. This study introduces a 3D scene reconstruction and rendering strategy based on implicit neural representation through the efficient and removable neural radiation fields model (NeRF-RE). Leveraging neural radiance fields (NeRF), the model incorporates a multi-resolution hash grid and proposal network to improve training efficiency and modeling accuracy, while integrating a segment-anything model to safeguard public privacy. Take the crabapple tree, extensively utilized in urban garden design across temperate regions of the Northern Hemisphere. A dataset comprising 660 images of crabapple trees exhibiting three distinct geometric forms is collected to assess the NeRF-RE model’s performance. The results demonstrated that the ‘harvest gold’ crabapple scene had the highest reconstruction accuracy, with PSNR, LPIPS and SSIM of 24.80 dB, 0.34 and 0.74, respectively. Compared to the Mip-NeRF 360 model, the NeRF-RE model not only showed an up to 21-fold increase in training efficiency for three types of crabapple trees, but also exhibited a less pronounced impact of dataset size on reconstruction accuracy. This study reconstructs real scenes with high fidelity using virtual reality technology. It not only facilitates people’s personal enjoyment of the beauty of natural gardens at home, but also makes certain contributions to the publicity and promotion of urban landscapes. Full article

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

The contemporary food environment is experiencing substantial transformations, and sustainability and the pursuit of novel ingredients have become pivotal factors in consumer decision-making and business strategy formulation. The emergence of alternative proteins has significant implications for sustainability, climate change mitigation and animal welfare, and can potentially promote the achievement of different United Nations Sustainable Development Goals. The spread of these novel foods requires significant attention, particularly concerning younger demographics, which are often considered to be more environmentally and ethically aware when making dietary choices. This study investigates the psychological and attitudinal factors that shape young consumers’ intention to consume plant-based, insect-based, and cultured meat alternative proteins, and verifies the existence of heterogeneous segments of consumers. To this purpose principal component analysis and k-means cluster analysis are employed using data from an online survey conducted in Italy, with a sample of 350 young consumers. The findings reveal that the intention to consume alternative protein sources is not particularly pronounced among the young consumers and differs according to the type of alternative protein. Three different profiles of young consumers were found: traditionalist (39% of the sample); enthusiastic (17%) and open-minded (44%). These segments differ significantly with respect to consumption intention, socio-demographic, lifestyle and psychological variables. The results provide useful insights for policymakers to design targeted interventions to encourage young consumers’ sustainable food choices. The findings could also be useful for marketers interested in investing in such innovations as they can benefit from an in-depth knowledge of this market segment. Full article

Objectives: In healthy young adults, thoracic kyphosis can be attributed to a number of factors, including a sedentary lifestyle, stress, poor posture, activity and daily habits, muscle pain, fatigue, and anxiety. In regard to clinical diagnosis and evaluation methods, high-cost radiological measurements and a variety of non-radiological clinical methods are employed. In this study, a decision support system that performs automatic thoracic kyphosis angle measurements has been developed with the objective of avoiding exposure of the human body to radiation and reducing the time required for measurements. Methods: The features were determined with reference to the thoracic kyphosis measurements that were manually marked by the expert on the subjects. The kyphosis angle was calculated by automatically identifying the T1 and T12 points through image segmentation using a convolutional neural network (CNN), which is a type of deep learning algorithm. Results: Intra-class consistency of ICC > 0.95 (p < 0.05) and internal consistency reliability of Cronbach’s α = 0.947 are obtained. Conclusions: The results demonstrate that the proposed algorithm exhibits high intra-class consistency and high internal consistency reliability to provide an automated thoracic kyphosis angle measurement system. Full article

The prevalence of car dependence and sedentary lifestyles has created concern in the transportation and health sectors. Walking is the most popular and practical kind of exercise that can significantly enhance health. In Chile, more than half of older adults have health issues and almost 72% of the elderly population never engages in physical activity. This study aims to investigate the relationship between older adults’ walking behavior and the built environment along the streets and parks in Santiago’s middle-income neighborhoods. Six medium-income central and pericentral neighborhoods of Santiago were selected. The average number of older persons who walk along the paths and two modified audit forms were used to measure walking behavior and built environment features, respectively. Both correlation analysis and backward regression were used to examine the associations. While elements like the existence of bus stops, pedestrian streets, and general cleanliness contribute to the enhanced number of older adults who walk along street segments, the presence of insecurity signs was found to be negatively associated with the number of older adults who walk in the neighborhood parks. Furthermore, complexity and mystery showed a negative association with the number of older adults in the neighborhood parks. Urban policymakers might use these findings to encourage older adults to walk more in Santiago’s medium-income neighborhoods. Full article

Health and wellness tourism is a rapidly expanding segment of the global tourism industry, driven by increasing consumer awareness of well-being and lifestyle enhancement. As the demand for wellness travel grows, destinations are expected to offer high standards of safety, hygiene, rehabilitation, and holistic experiences. This study aims to identify and evaluate the key attributes and determinants for developing health and wellness tourism destinations by applying the 6As Tourism Development framework: Attractions, Accessibility, Amenities, Activities, Available Packages, and Ancillary Services. A multi-criteria decision-making approach, specifically the TOPSIS, was employed to assess destination potential through a case study of Nakhon Ratchasima Province, Thailand. The results indicate that Attractions, Accessibility, and Amenities are the top three priorities for wellness tourists. Sub-criteria such as natural scenery, cultural significance, accessibility for all, safety, and accommodation quality are particularly influential. Three districts in Nakhon Ratchasima were found to exhibit distinct strengths—Pak Chong is best suited for rehabilitative tourism (e.g., aroma and water therapy), aligning with mind and nutrition wellness components; Wang Nam Khiao is ideal for ecotourism and cultural experiences, supporting environmental and nutritional dimensions; while Mueang Nakhon Ratchasima excels in sports tourism, supporting physical and nutritional well-being. The study offers practical insights for policymakers and tourism stakeholders to design sustainable, visitor-centered wellness destinations. The proposed framework supports strategic planning and resource allocation for health-focused tourism development. Full article