Search Results (849)

This review aimed to be comprehensive and to critically analyze the factors that may affect the macronutrient and energy content of breast milk. Systematic reviews were prioritized, even though other types of literature reviews on the subject, as well as studies not included in these reviews, were included. Reported factors that potentially affect the macronutrient and energy content of breast milk comprise: maternal factors, such as age, nutritional status, dietary intake, smoking habits, lactation stage, circadian rhythmicity, and the use of galactagogues; obstetrical factors, such as parity, preterm delivery, multiple pregnancies, labor and delivery, and pregnancy morbidities including intrauterine growth restriction, hypertensive disorders, and gestational diabetes mellitus; and newborn factors, including sexual dimorphism, and anthropometry at birth. Some factors underwent a less robust assessment, while others underwent a more in-depth analysis. For example, the milk from overweight and obese mothers has been reported to be richer in energy and fat. A progressive decrease in protein content and an increase in fat content was described over time during lactation. The milk from mothers with hypertensive disorders may have a higher protein content. Higher protein and energy content has been found in early milk from mothers who delivered prematurely. Full article

Dietary protein is an essential macronutrient derived from both plant and animal sources required for muscle building, immune function, and wound healing. However, in the United States, protein consumption worsens as individuals age, with 30% of men and 50% of women over 71 consuming inadequate dietary protein due to a variety of factors, including changes in gut function, loss of appetite, tooth loss, financial concerns, and social isolation. The aim of this review is to underscore the need for increased protein requirements in aging populations, highlight potential barriers, synthesize these protein requirements, and also recommend strategies to meet these increased protein needs. Achieving adequate protein status, especially when facing chronic or acute health concerns, is essential to promote muscle and bone strength (because aging is associated with significant decreases in postprandial muscle protein synthesis), to support immune health (due to immunosenescence), and to maintain a good quality of life. For older adults, the literature suggests that a dietary protein intake of at least 1.0–1.2 g/kg/day is required in healthy, aging populations, and intakes of 1.2–1.5 g/kg/day are necessary for those with chronic or acute conditions. These protein intake recommendations can increase to 2.0 g/kg/day in more severe cases of illness, malnutrition, and chronic conditions. The reviewed literature also suggests that evenly balanced protein distributions of 25–30 g of dietary protein (0.4 g/kg) per meal from animal and plant protein sources alike are sufficient to maximize muscle protein synthesis (MPS) rates in older populations. Additionally, pre-sleep protein feeds of 40 g/night may be another strategy to improve daily MPS and amino acid utilization. Full article

Children and adolescents with type 1 diabetes (T1D) often experience abnormalities in bone health. Studies have consistently demonstrated that youth with T1D have lower bone mineral density (BMD) compared to their healthy peers. Additionally, children with T1D show impaired bone microarchitecture and reduced bone turnover. These factors collectively contribute to an increased risk of fractures across the life span of this population. To optimize bone accrual and reduce fracture risk, several strategies can be employed during childhood and adolescence. First, maintaining good glycemic control is critical, as poor glycemic control has been associated with lower BMD and an increased risk of fractures. Second, specific nutritional recommendations can help improve bone health, including a balanced diet, adequate calcium and vitamin D intake, and careful monitoring of both macronutrient and micronutrient intake. Third, regular physical activity plays a vital role. A systematic review and meta-analysis have shown that youth with T1D are generally less physically active, more sedentary, and have lower cardiorespiratory fitness levels than their non-diabetic peers. This review emphasizes targeted strategies aimed at optimizing skeletal health in the pediatric population with T1D, with a particular focus on the critical roles of glycemic control, nutritional adequacy, and regular physical activity. These modifiable factors may contribute to the reduction of fracture risk across the life span in individuals with T1D. Full article

Objectives: This study aimed to investigate both the linear and non-linear associations between serum 25-hydroxyvitamin D [25(OH)D] levels and serum uric acid concentrations in Korean adults, with a particular focus on the vitamin D-insufficient range (<30 ng/mL), and to explore the potential metabolic implications of this relationship. Methods: Using data from the Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed 10,864 adults aged 19 years and older. Serum vitamin D levels were categorized into quartiles (Q1–Q4), and their relationships with uric acid concentrations were examined using Pearson correlation, analysis of variance (ANOVA), and restricted cubic spline regression. Multivariate models were adjusted for potential confounders including age, sex, body mass index (BMI), kidney function, chronic disease status, and macronutrient intake. Results: In unadjusted analysis, a statistically significant but weak negative correlation was observed between serum 25(OH)D and uric acid levels (Pearson’s r = −0.092, p < 0.001). However, in multivariate regression adjusting for confounders, a weak positive association emerged. Restricted cubic spline analysis revealed significant positive associations in the lower quartiles (Q1–Q3), with the strongest association in Q3 (β = 0.769, 95% CI: 0.34–1.19, p < 0.001). No significant association was observed in the highest quartile (Q4). Conclusions: Serum vitamin D and uric acid concentrations show a non-linear relationship, with a significant positive association within the vitamin D-insufficient range (<30 ng/mL). These findings provide new insights into the potential metabolic role of vitamin D and highlight the need for longitudinal and interventional studies to clarify causality and clinical significance. Full article

Background: Gestational diabetes mellitus (GDM) affects 7–9% of pregnancies worldwide and is associated with adverse maternal and neonatal outcomes. Nutritional therapy is a key component of GDM management. However, inconsistencies exist across international and national guidelines regarding macronutrient distribution, glycemic targets, and micronutrient supplementation. This systematic review aims to compare updated nutritional recommendations for GDM across major health organizations and identify areas of consensus, divergence, and evidence gaps. Methods: This systematic review was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251026194). A comprehensive literature search was performed in PubMed, Scopus, and Google Scholar (concluding March 2025), along with manual searches of official websites of professional health organizations (e.g., ADA, WHO, NICE, IDF). Guidelines published within the last 10 years (or the most relevant national guideline if slightly older), available in English or with access to translation, and including explicit nutritional recommendations for GDM were included. Data were extracted on macronutrient composition, glycemic targets, and micronutrient supplementation, with evaluation of the supporting evidence and regional context, incorporating findings from recent key guideline updates. Results: In total, 12 guidelines met the inclusion criteria. While all guidelines emphasized carbohydrate moderation and adequate fiber intake, significant discrepancies were found in carbohydrate quality recommendations (e.g., low-glycemic index focus vs. total carbohydrate restriction), postprandial glucose targets (e.g., 1-h vs. 2-h measurements and varying thresholds like <120 vs. <140 mg/dL), and the use of non-routine micronutrients such as chromium, selenium, and omega-3 fatty acids (generally lacking endorsement). Recent updates from key bodies like ADA, Diabetes Canada, and KDA largely maintain these core stances but show increasing emphasis on dietary patterns and acknowledgement of CGM technology, without resolving key discrepancies. Cultural adaptability and behavioral counselling strategies were minimally addressed across most guidelines. Conclusions: Despite general agreement on the principal recommendations of nutritional management in GDM, substantial variation persists in specific recommendations, even considering recent updates. Consistent, evidence-based, and culturally adaptable guidelines incorporating implementation strategies are needed to optimize care and reduce disparities in GDM management across regions. Full article

Type 2 diabetes (T2D) represents a public health problem globally, with the highest prevalence reported among older adults. While an interplay of various determinants including genetic, epigenetic, environmental factors and unhealthy lifestyle, particularly diet, has been established to contribute to T2D development, emerging evidence supports the role of interactions between nutrients or dietary patterns and genes in the pathogenesis of this metabolic disorder. The amount, and especially the type of carbohydrates, in particular, have been correlated with the risk of non-communicable chronic disease and mortality. This narrative review aims to discuss the updated data on the complex and not fully elucidated relationship between carbohydrate–gene interactions and incidence of T2D, identifying the most susceptible genes able to modulate the dual association between carbohydrate intake and risk of developing T2D. The identification of genetic polymorphisms in response to this macronutrient represents a potentially powerful target to estimate individual risk and prevent the development of T2D in the context of personalized medicine. The postulation around novel foods potentially tailored to minimize the risks of developing T2D will pave the way for a new era into food research in relation to the safeguarding of well-being status in patients affected by, or at risk for, T2D. Full article

Background: The Fit-Model in bodybuilding is a relatively new category designed for women seeking a balanced physique, avoiding excessive muscularity and extreme leanness. This study examined the dietary strategies, body composition changes, and plasma leptin fluctuations of Fit-Model athletes during a seven-week pre-competition phase. Methods: Twelve females (age: 27.6 ± 4.4 years, body mass: 60.0 ± 6.2 kg) preparing for a national championship were monitored for energy and macronutrient intakes, total, lean, and fat mass, plasma leptin levels, and menstrual cycle characteristics. The five highest-ranked athletes were selected to compete at the world championship, allowing for comparisons between national and international athletes. Results: Low carbohydrate intake was reported, and total energy intake decreased from 1700 to 1520 kcal/day approaching the contest day. Athletes experienced an average body mass loss of 4.2 kg, with no clear relationship between final weight or fat mass and competitive success. Plasma leptin levels were markedly low during all 7 weeks of preparation with a further decline before the contest, but did not correlate with either changes in body composition and weight or energy or macronutrient intakes. Menstrual cycle disturbances were prevalent, with only two athletes maintaining regular cycles by the end of the preparation. Conclusions: Fit-Model athletes undergo a considerable decline in body weight and fat mass during the final weeks before the contest, yet these changes do not appear to be decisive for performance outcomes. Persistently low leptin levels and menstrual irregularities call for strategies that balance physique optimization with endocrine health to support both the performance and well-being of athletes. Full article

Background/Objectives: The role of maternal diet in atopic dermatitis (AD) requires better understanding, as AD often manifests early in life and precedes other allergic diseases. We evaluated the association between maternal diet and AD up to 2 years of age. Methods: A total of 116 mother–child dyads from the CARE birth cohort study were included. Maternal diet during pregnancy was assessed with a validated self-administered 97-item food frequency questionnaire, and dietary scores were calculated. AD was evaluated at ages 4 months, 1 year, and 2 years. The associations between maternal dietary patterns and AD were examined by logistic regression analysis adjusting for total energy intake, gender of the child, maternal antibiotic therapy during pregnancy, and history of atopic disease among both parents. Results: Of the 116 children, 27 (23.3%) developed AD by 2 years, 11 of whom (40.7%) had persistent AD within the first 2 years. AD risk was reduced with a higher Mediterranean diet score during pregnancy (upper median > 3 points versus lower median: adjusted OR 0.24, 95% CI 0.08–0.69, p = 0.009) and with greater dietary diversity, as measured by the number of items consumed (upper median > 53 items versus lower median: OR 0.19, 95% CI 0.06–0.58, p = 0.005). No association was found with macronutrients and micronutrients. Red meat consumption showed a positive association with the persistent AD phenotype (adjusted OR 5.04, 95% CI 1.47 to 31.36, p = 0.034). Conclusions: Adherence to a Mediterranean diet and a diverse diet during pregnancy may decrease the risk of developing early childhood AD. This highlights the synergistic role of nutrients in dietary patterns as they modulate immune development and disease susceptibility. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), are growing global health concerns. However, pharmacological therapies for MASLD/MASH have not yet been established. Dietary interventions and their bioactive components have been explored as strategies to mitigate MASLD and MASH progression. Although specific nutrients and bioactive compounds have exhibited potential therapeutic benefits, they also exacerbate adverse outcomes. In this comprehensive review, we synthesize the protective and exacerbating or sometimes dual effects of key macronutrients, including fatty acids (saturated, unsaturated, and trans fats) and carbohydrates (fructose, glucose, and sucrose), and bioactive compounds and micronutrients, in the context of MASLD management. The evidence suggests that coffee-derived compounds, such as caffeine and chlorogenic acid, may attenuate liver injury. However, the effects on MASLD severity are inconsistent. Diets high in saturated fatty acids exacerbate MASLD pathogenesis, whereas moderate intake (7–10% of total energy) may confer metabolic benefits. Other bioactive compounds and micronutrients have been explored for their diverse roles in hepatic lipid metabolism and insulin sensitivity. Although current evidence supports the therapeutic potential of specific dietary nutrients and bioactive compounds in the management of MASLD, inconsistencies in results highlight the need for more robust, well-controlled studies, including clinical trials, to clarify the preventive and therapeutic standards for balanced food interventions in MASLD management. In particular, well-designed clinical trials are necessary before clinical application. Although this is a narrative review and the literature retrieval may be biased, we covered a wide variety of substances. Full article

Background/Objectives: Assessing oral intake in patients with disease-related malnutrition (DRM) and sarcopenia remains a clinical challenge. This study aimed to evaluate the relationship between oral intake adjusted to nutritional requirements and the presence of sarcopenia in patients with DRM. Methods: This was a prospective observational study involving 118 outpatients with DRM, diagnosed according to Global Leadership Initiative on Malnutrition criteria. Sarcopenia was assessed using the European Working Group on Sarcopenia in Older People criteria. A 3-day dietary intake record was collected at the beginning of nutritional follow-up. Caloric (kcal/day) and protein (g/day) intakes were calculated. Energy needs were estimated using the Harris-Benedict equation with stress factors, and protein needs were set at 1.5 g/kg/day. Intake was categorized based on whether energy and protein intake exceeded or fell below 70% of requirements. Results: The mean age was 62.2 years, and 58.8% were female. Sarcopenia was present in 42% of patients. No significant difference was found in body mass index between patients with and without sarcopenia. Mean caloric intake was 29.6 kcal/kg/day and protein intake was 1.3 g/kg/day. Average fulfilment was 78.3% for energy and 86.8% for protein. Patients with sarcopenia had significantly lower intake of calories and macronutrients. Sarcopenia was more prevalent in those with <70% fulfilment of caloric and protein requirements. Multivariate analysis showed increased risk of sarcopenia (Odds ratio (OR): 4.27; 95% Confidence Interval (CI): 1.30–14.03; p = 0.017) and severe malnutrition (OR: 5.17; 95% CI: 1.63–16.42; p < 0.01) in patients with low protein intake. Conclusions: In patients with DRM, insufficient intake of calories and protein was associated with a higher prevalence of sarcopenia. There was an increased risk of sarcopenia and severe malnutrition in patients with lower protein intake. Full article

Background: Endocrine therapies are accompanied by side effects that significantly impact the quality of life (QoL) of women with breast cancer. Adequate diet is important for fulfilling nutritional requirements, preserving health, and supporting therapy in this vulnerable population. Methods: This preliminary study evaluated the QoL of life and dietary intake in 185 women with breast cancer on two therapies, aromatase inhibitors (AIs) and tamoxifen, using the Functional Assessment of Cancer Therapy—Endocrine Symptoms (FACT-ES), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and Breast Cancer Specific Questionnaire (QLQ-BR23) and a 24 h dietary recall. A total of 185 women were included in the study and fulfilled the FACT-ES, of whom 73 fulfilled other two questionnaires and a 24 h recall. Results: No significant differences were found in the overall QoL between groups. Joint pain (95.3%) and reduced libido (84.7%) were most common with AIs, while tamoxifen users more frequently reported weight gain and irritability (93.0%, each), and vasomotor and gynecological symptoms. Macronutrient intake was similar, though AIs users consumed more energy-dense (p ≤ 0.001) and sugary foods (p = 0.034), while tamoxifen users had higher omega-6 PUFA intake. Both groups exhibited suboptimal intake of vitamin D, calcium, and selenium, and a higher phosphorus consumption relative to recommended daily values. Conclusions: Preliminary findings showed that QoL and dietary intake were comparable between patients with BC on AIs and tamoxifen treatment. Endocrine-related symptoms were more prevalent among tamoxifen users, whereas joint pain was most common in AIs users. Nutritional interventions may be warranted in both groups to ensure adequate intake of essential micronutrients in accordance with recommended dietary guidelines. Full article

Pollen, the male gametophyte of flowering plants, is collected by honeybees as a primary source of protein and converted into bee pollen through the enzymatic activity of digestive secretions. The nutrients in bee pollen are available in amounts well beyond those of proteins, comprising macronutrients such as carbohydrates, lipids and dietary fiber, as well as micronutrients such as minerals, vitamins, organic acids, and phenolic compounds. This study aimed to determine the macro and trace mineral content of bee pollen from different botanical and geographical origins, and to assess their bioaccessibility through simulated in vitro digestion, their dietary contribution, and potential health risks. Seven bee pollen samples were investigated, three with a monofloral origin of above 80%, from Nigella spp., Helianthus annuus and Castanea sativa, and four with a multifloral origin. Mineral composition revealed potassium as the most abundant element, while iron, manganese, and copper were found at trace levels. Castanea sativa pollen had the highest overall mineral content, whereas Nigella spp. showed the lowest values for calcium, magnesium, and copper. The bioaccessibility of bee pollen was highest during the gastric phase for most minerals except copper, where most of the samples peaked in the intestinal phase. Overall, mineral bioaccessibility after simulated digestion followed the order K > Mg > Cu > Ca > Mn > Fe > Zn. While for manganese, the consumption of bee pollen showed the highest contribution to recommended dietary intake (16% for women and 12% for men), calcium had the lowest, with less than 1% of the RDA at a consumption level of 40 g/day. Health risk assessment confirmed that consuming 40 g/day of bee pollen poses no risk because the target hazard quotient and hazard index are below the risk threshold of 1.0. Full article

Background: Dietary patterns impact blood pressure (BP) levels, but the potential impact of replacing specific types of fats with proteins or carbohydrates, in isocaloric models, on BP remains unclear. Objective: This study evaluates the longitudinal association between the substitution of different types of fats with proteins or carbohydrates and changes in BP in a Mexican population. Methods: We analyzed data from 1448 adults (mean age at baseline: 45 years; 73.3% women) from the Health Workers Cohort Study, followed over 13 years. Trained personnel measured systolic (SBP) and diastolic (DBP) blood pressure following standard procedures and techniques at baseline and follow-up. Macronutrient intake was assessed with a validated semi-quantitative food frequency questionnaire. Generalized Estimating Equations (GEE) for hypertension and fixed-effects linear regression for BP were conducted using isocaloric substitution models. Each estimate reflects the effect of a 3% energy substitution of specific fats for carbohydrates or proteins. Results: Substituting 3% of energy intake of polyunsaturated fat (PUFA) in place of vegetable protein (β = −2.94, 95% CI: −5.02, −0.86), animal protein (β = −2.68, 95% CI: −4.73, −0.63), low glycemic index (LGI) carbohydrates (β = −2.63, 95% CI: −4.40, −0.86), and high glycemic index (HGI) carbohydrates (β = −2.52, 95% CI: −4.31, −0.74) was associated with a significant reduction in SBP. Substituting 3% of the energy intake of PUFA in place of different types of carbohydrates was associated with lower odds of hypertension. PUFA was not associated with changes in DBP. Conclusions: Our findings suggest that exchanging PUFA for carbohydrates or proteins is associated with reduced SBP and a lower risk of hypertension, highlighting the importance of macronutrient composition independent of total energy intake and other fat types, which may have a substantial impact at the population level. Full article

Background/Objectives: Previous literature shows that the demographic characteristics of caregivers, such as educational level, determine health processes in young children. However, the mechanisms through which educational level increases health in this population have scarcely been explored in low- and middle-income countries (LMICs). Evidence also suggests that caregivers who model healthy eating to their children, such as eating healthy foods in front of them or enjoying the consumption of healthy foods, increase the likelihood that their child will do the same. Methods: Eighty-two primary caregivers of children between 3 and 5 years of age in Costa Rica completed an electronic questionnaire with measures on the highest educational level attained, modeling the healthy eating and diet diversity of their children. Diet diversity indicates the intake of seven important groups of macronutrients that are needed for healthy development in Costa Rican children. Results: To investigate these relationships, a simple mediation analysis was carried out, with diet diversity as an outcome, caregiver educational level as a predictor, and modeling as a mediator. The indirect effect of educational level on diet diversity was found to be statistically significant [Effect size = 0.10, 95% C.I. (0.01–0.20)]; Conclusions: Results indicate that high educational level is associated with increased usage of healthy eating modeling with children, and this in turn is positively related to their diet being more diverse. Results suggest that the modeling of healthy eating could be the object of interventions aimed at preventing obesity in Costa Rican children. Full article

Background: This study aimed to evaluate the impact of physical activity levels on selected biochemical markers (glucose, insulin, cholesterol, triglycerides, interleukin-6 [IL-6]), brain-derived neurotrophic factor (BDNF), cognitive functions, and additional macronutrient intake in postmenopausal women. Method: A total of 72 generally healthy women aged 55–73 from western Poland participated in the study. Physical activity levels were assessed using the International Physical Activity Questionnaire (IPAQ), resulting in two distinct groups: 56 women in the lower activity level group and 16 in the higher activity level group. We calculated body mass index (BMI), measured body composition and blood pressure, and conducted cognitive assessments, including the Mini-Mental State Examination (MMSE), motor and psychomotor skills tests, the Clock Drawing Test, and the Geriatric Depression Scale (GDS). Nutritional intake was evaluated using a detailed 3-day food record to analyze macronutrient consumption and total caloric intake. Results: A statistically significant difference in total blood cholesterol levels (p = 0.0277) was observed between the two groups, with the higher physical activity group showing elevated cholesterol levels. Although no other biochemical markers showed statistically significant differences, variations in BDNF, glucose, triglycerides, IL-6, and insulin levels were noted between groups. Moreover, correlations between these markers and cognitive performance, like motor and psychomotor speeds, varied depending on physical activity level. The analyzed dietary pattern of the studied group shows slight deviations from current nutritional recommendations. Conclusions: The findings suggest that physical activity level may influence certain biochemical markers and cognitive functions in postmenopausal women. While these results highlight the potential benefits of physical activity, further research is needed to clarify underlying mechanisms and to validate physical activity as an effective strategy for improving postmenopausal health. Full article