Search Results (462)

Background/Objectives: Excessive sodium (primarily from sodium chloride, NaCl) intake remains one of the leading dietary risk factors associated with hypertension, cardiovascular disease, and other chronic health conditions worldwide. Commercial diet catering services providing ready-to-eat daily meal plans have become increasingly popular and are often perceived as nutritionally balanced; however, analytical evidence regarding their actual salt content remains limited. The aim of this study was to evaluate the NaCl content of daily food rations (DFRs) offered by commercial diet catering services in Poland. Methods: A total of 120 DFRs representing three dietary patterns (Hashimoto diet, DASH diet, and low-carbohydrate diet) were collected from 40 catering providers. Sodium chloride content was determined using the Mohr titration method. Sodium intake values were estimated by conversion from NaCl equivalents to allow comparison with dietary recommendations. Results: The median NaCl content across all analyzed diets was 14.19 g/day (Q1: 10.62 g; Q3: 17.49 g), corresponding to approximately 284% of the World Health Organization recommended maximum intake of 5 g/day of salt. Nearly half of the analyzed DFRs (45.83%) exceeded the recommended intake by more than threefold. Overall, 99.2% of the analyzed DFRs exceeded recommended NaCl intake levels, while 91.9% did not comply with the values declared by manufacturers. DFRs consisting of five meals contained higher NaCl levels than three-meal plans (p < 0.0196); however, this difference may be related to variation in total food mass rather than meal frequency, as the number of meals was confounded with diet type. Conclusions: These findings suggest that commercially prepared diet catering meals may represent a substantial source of dietary NaCl when used as a primary daily food source. Improved nutritional monitoring, clearer nutrient reporting, and quality control of commercially prepared dietary plans may support public health strategies aimed at reducing NaCl intake. Full article

This study aimed to assess the effect of concentrate supplementation frequency on the nutrient intake, performance, carcass characteristics, and tissue composition of sheep for meat raised on Panicum maximum cv. Massai pasture. A group of 36 sheep of the Santa Inês breed (18 males and 18 females) with a mean initial weight of 17.0 ± 1.5 kg and mean age of 90 ± 10 days were assigned to three treatments: supplementation every 24 h, every 48 h, and every 72 h. The formulation comprised ground maize kernels (70%), soybean meal (25%), mineral mix (2.5%), urea (1.8%), table salt (0.5%), and ammonium sulfate (0.2%). The females reached a higher final weight than the males (p < 0.05). Dry matter intake did not differ among the treatment groups (p > 0.05), but the sheep supplemented every 72 h showed greater pasture and neutral detergent fiber (NDF) intake, while those supplemented every 24 h and 48 h consumed more concentrate and had higher total weight gain (7.19 and 7.10 × 5.68 kg) (p < 0.05). The same behavior was found for carcass and meat cut weights and for leg and carcass compacity indexes, but carcass and cut yields were not impacted by supplementation strategy. Supplementation on alternate days, i.e., every 48 h, maintains the performance and productive efficiency levels in sheep kept on Massai grass pasture compared to those supplemented daily, but providing intermittent supplementation with intervals above 48 h is not recommended as a nutritional strategy. Full article

Background: Early Childhood Caries (ECC) is a prevalent multifactorial disease strongly influenced by dietary and behavioral factors. Night-time feeding practices and sugar exposure have been implicated, yet the relative impact of feeding duration, feeding type, and oral hygiene remains debated. This study aimed to investigate the association between ECC and major dietary and behavioral risk factors, with particular emphasis on the presence and duration of night-time feeding, in a pediatric population from Southern Italy. Methods: A single-center retrospective observational study was conducted on medical records of children aged 1–6 years referred for a first dental visit to a pediatric dentistry unit. ECC and severe ECC (S-ECC) were diagnosed according to AAPD criteria. Data on night-time feeding (presence and duration), sugar-rich diet, number of daily meals, oral hygiene habits, and age at initiation of toothbrushing were collected through structured interviews. Associations were evaluated using chi-square tests and multivariable logistic regression analysis, with ECC/S-ECC as the dependent variable. Results: A total of 248 children were included. ECC/S-ECC prevalence was 62.5%. A sugar-rich diet was associated with increased ECC risk (OR = 4.14, p < 0.001). Prolonged night-time feeding showed a dose–response relationship with ECC, with risk increasing beyond 12 months and exceeding twelvefold for durations > 24 months. Multivariable analysis showed that night-time feeding duration > 12 months, high-sugar diet, >5 daily meals, and delayed initiation of toothbrushing were associated with ECC, whereas use of an electric toothbrush and fluoridated toothpaste showed a trend toward a protective effect. Feeding type was not independently associated with ECC after adjustment for duration. Conclusions: Duration of night-time feeding, rather than feeding type, represents a key modifiable determinant of ECC risk. Preventive strategies should prioritize early cessation of night-time feeding, reduction in sugar exposure, limitation of meal frequency, and early introduction of effective oral hygiene with fluoride. Full article

Background/Objectives: Appropriate nutritional management constitutes one of the key elements of conservative treatment and renal replacement therapy in patients with chronic kidney disease (CKD). The level of patients’ nutritional knowledge may significantly influence adherence to dietary recommendations, the rate of disease progression, and the frequency of complications. The aim of this study was to assess the level of nutritional knowledge, dietary habits, adherence to dietary recommendations, and nutritional status of patients with CKD according to disease stage. Methods: This cross-sectional study was conducted among 98 adult patients diagnosed with CKD. A questionnaire assessing nutritional knowledge and dietary behaviors was administered. An overall nutritional knowledge score was calculated based on eight questionnaire items assessing nutritional knowledge. Nutritional status was evaluated using the Subjective Global Assessment (SGA) and the Simplified Nutritional Appetite Questionnaire (SNAQ). Anthropometric, clinical, and biochemical data were collected. Statistical analysis was performed using tests appropriate to the data distribution. Results: The level of nutritional knowledge varied and was dependent on CKD stage. Patients in more advanced stages of the disease demonstrated significantly higher awareness of dietary recommendations compared with those in earlier stages. The median nutritional knowledge score was 6 points, with 46.9% of participants demonstrating insufficient knowledge (<6 points) and 53.1% achieving adequate knowledge (≥6 points). The greatest knowledge deficits concerned the control of phosphorus, potassium, sodium, and fluid intake. Discrepancies were also observed between declared knowledge and actual dietary behaviors. Good nutritional status (SGA A) was identified in 73 patients, risk of malnutrition or moderate malnutrition (SGA B) in 22 individuals, and severe malnutrition (SGA C) in 3 patients. SNAQ indicated good appetite in the study population, with an average consumption of three meals per day, and identified a risk of weight loss in 6% of patients. Overweight and obesity were present in more than half of the study population, while underweight was observed in 4%. Conclusions: Nutritional knowledge among patients with CKD remains insufficient, particularly in the early stages of the disease. The findings highlight the necessity of early and systematic implementation of individualized nutritional education as an integral component of slowing disease progression. Full article

Background/Objectives: Sensory processing disorders (SID) are common in children with autism spectrum disorder (ASD) and can influence children’s eating behaviors. Evaluating the nutritional status of children with ASD is crucial for families or caregivers to manage their feeding. Therefore, this study aimed to compare the eating behaviors and dietary intake between children with ASD and children with ASD + SID. Methods: This cross-sectional study included 72 children with ASD aged 6–15 years, of whom 36 also had SID. Sociodemographic information and dietary habits of children were collected. The children’s body weight and height were measured. Children’s eating behaviors were assessed using the Children’s Eating Behavior Scale. Dietary intake was obtained using 3-day food consumption records. Results: The rate of overweight was higher in children with ASD compared to children with ASD + SID, but there was no statistically significant difference between the groups (p > 0.05). Children with ASD + SID were more likely to skip main meals than children with ASD (p < 0.05). Children with ASD + SID had significantly lower dietary reference intake levels of energy, macronutrients, fiber, PUFAs, vitamin E, B1, B6, folate, potassium, calcium, magnesium, phosphorus, and iron compared to children with ASD (p < 0.05). Increased scores on the drinking passion subscale were identified as a risk factor for SID (OR = 2.15, 95% CI [1.30, 4.30], p = 0.005). Conclusions: The higher frequency of skipping main meals, significantly lower energy and nutrient intake in the ASD + SID group indicates that these children are at higher nutritional risk. Incorporating sensory-based assessments and interventions into nutritional management may be crucial. Full article

Background: Nutritional status and lifestyle factors are increasingly recognized as relevant modulators of women’s reproductive health. However, data remain limited on the relationship between body composition, dietary habits, and menstrual cycle characteristics in apparently healthy young women. This study aimed to assess nutritional status, body composition, and lifestyle behaviors in young women and to explore their associations with menstrual cycle regularity. Methods: This cross-sectional study included 49 apparently healthy women aged 19–30 years. Anthropometric measurements and body composition were assessed using bioelectrical impedance analysis. Dietary habits were evaluated through a simplified food frequency questionnaire, and adherence to the Mediterranean diet was assessed using the PREDIMED score. Physical activity was estimated using MET values based on the Compendium of Physical Activities. Menstrual cycle characteristics were collected via questionnaire. Group comparisons were performed between women with regular and irregular menstrual cycles. Results: The sample was predominantly normal-weight (mean BMI 22.36 ± 4.26 kg/m²). Anthropometric and bioelectrical impedance parameters did not differ significantly between women with regular and irregular cycles. Women with irregular cycles showed higher resistance and extracellular water and lower phase angle and body cell mass, although differences were not statistically significant. A significant association was found for meat consumption, which was lower in women with irregular cycles (p = 0.007). No associations were observed for other dietary variables, physical activity, or meal frequency. Conclusions: Menstrual regularity in young women was not associated with major anthropometric differences but may be linked to subtle aspects of nutritional status and dietary habits. Lower meat consumption emerged as a potential dietary factor associated with menstrual irregularity. Although associations were modest, these findings support the relevance of nutritional and lifestyle factors in menstrual health. Larger longitudinal studies are needed to clarify these relationships. Full article

Background: Hospital nutrition is an essential component of patient care; however, the nutritional quality of meals in Polish hospitals has raised concerns for many years. In response to these challenges, the Ministry of Health implemented a nationwide pilot program, “Good Meal in the Hospital,” to improve nutritional quality by developing and implementing a model tailored to patients’ needs. This study aimed to assess the compliance of hospital-standard diets with the program’s assumptions. Methods: Ten-day menus from ten hospitals across different regions of Poland (a total of 100 menus) were analyzed. A quantitative assessment of energy and nutritional values was conducted by calculating the average daily intake of energy and selected nutrients (protein, carbohydrates including sugars (mono- and disaccharides), fat, saturated fatty acids, fiber, and salt) and comparing these with national recommendations for hospital diets for adults. In parallel, a qualitative assessment of ten menu structure criteria was performed using a binary scoring system (0/1). Results: None of the analyzed hospitals met all quantitative and qualitative criteria simultaneously. All hospitals complied with recommendations for protein and carbohydrate content, whereas the most frequent deviations concerned excessive intake of fat, saturated fatty acids, and salt. Qualitative scores ranged from 6 to 10 points, with the most significant shortcomings related to the frequency of legumes and fish. A particularly noteworthy finding was the discrepancy between qualitative and quantitative compliance of the menus. Conclusions: The fact that none of the analyzed hospitals met all program criteria simultaneously indicates the limited effectiveness of its implementation in its current form. Full article

Background: Young adulthood represents a critical period for the emergence of early metabolic disturbances, potentially influenced by dietary shifts toward convenience and ultra-processed foods. However, evidence linking dietary patterns and cooking practices with objective metabolic biomarkers in Romanian university students remains limited. Methods: This cross-sectional study included 693 students aged 18–24 years at the Victor Babeș University of Medicine and Pharmacy, Romania (June–July 2025). Dietary habits, food preferences, and cooking practices were assessed using a structured online questionnaire, while anthropometric and biochemical data were obtained from university health records. The primary outcome was glycated hemoglobin (HbA1c), a marker of average blood glucose levels over the previous 2–3 months. Prediabetes was defined as HbA1c 5.7–6.4%. Dietary patterns were identified using k-means clustering based on fast-food consumption frequency, main meal of the day, fruit and vegetable intake frequency, and predominant cooking method. Multivariable regression models assessed associations between dietary variables and glycemic or lipid outcomes. Results: Prediabetes prevalence was 21.1% (diabetes: 1.4%). Three dietary patterns were identified: health-conscious (prediabetes 15.4%), mixed (20.0%), and fast-food oriented (27.3%; χ² p = 0.003). Fast-food consumption frequency was independently associated with higher prediabetes risk (OR = 1.78 per category; 95% CI 1.38–2.30; p < 0.001) and higher HbA1c levels (β = 0.147; p < 0.001), while fruit and vegetable intake showed an inverse association with HbA1c (β = −0.109; p < 0.001). A dose–response relationship was observed between fast-food frequency and both HbA1c and prediabetes prevalence (p-trend < 0.001). An interaction between high-temperature cooking methods and frequent fast-food consumption was observed for HbA1c (p = 0.023). BMI and sex were the strongest predictors of lipid outcomes, although fast-food intake was associated with higher triglyceride levels (p = 0.034). Conclusions: Among Romanian university students, dietary patterns characterized by frequent fast-food consumption were associated with higher HbA1c levels and greater prediabetes prevalence. A high-temperature cooking method was associated with higher glycemic levels when combined with frequent fast-food intake. These findings suggest that early dietary behaviors during university years may be relevant for metabolic risk profiles in young adults. Full article

Objectives: This study aimed to investigate the possible association among texture, oral processing and starch digestive characteristics of hard-cooked (HP) and soft-cooked (SP) potato samples, as well as their acute postprandial glycemic and insulinemic response, when co-ingested with rice in a meal. Methods: HP and SP replaced one-third of rice carbohydrates. Postprandial glycemic and insulinemic responses were measured after test meal ingestion. In vitro experiments evaluated sample physicochemical properties. Results: HP retained more resistant starch (RS) and total phenolics than SP. When co-ingested with rice (HP + R), HP elicited more total chews, higher oral sensory exposure time, slower chewing frequency and longer eating duration. HP + R significantly reduced postprandial glucose iAUC, peak glucose and glycemic excursion. SP + R increased glycemic variability despite reduced iAUCglucose. HP + R also lowered iAUCinsulin, peak insulin and insulin resistance index. The hypoglycemic effect did not extend to the second meal, though composite iAUCglucose over 540 min was reduced. Conclusions: Partially substituting rice with hard-cooked potatoes may help stabilize postprandial glycemic and insulinemic responses, an effect largely attributable to RS retention. Full article

Background/Objectives: Food insecurity remains a growing public health concern among university populations, particularly international students who often face financial constraints, limited social support, and cultural adaptation challenges. This study investigated the association between food insecurity and dietary diversity among international students in Hungary, a population for whom empirical evidence remains limited. Methods: A cross-sectional survey was conducted among 380 international university students using a structured questionnaire comprising sociodemographic items, the Food Insecurity Experience Scale (FIES), and a quantitative Food Frequency Questionnaire (FFQ). Dietary diversity was assessed through Food Group Diversity Score (FGDS) and Food Variety Score (FVS). Statistical analyses included chi-square tests, ANOVA, correlation analyses, and multiple regression using IBM SPSS 28.0. Results: Overall, 62% of participants experienced food insecurity, with 25% moderately and 20% severely food insecure, while 17% were classified as mildly food insecure. While 97% achieved high dietary diversity, only 31% exhibited high food variety. Group comparisons indicated differences in FGDS across food security categories (p = 0.006), whereas FVS did not differ significantly (p = 0.411). In multivariable regression models adjusting for socioeconomic and behavioural factors, food security status was not independently associated with FGDS or FVS. However, scholarship status, monthly income, employment, and meal skipping were significant predictors of dietary diversity indicators. Conclusions: These findings suggest that while food insecurity is prevalent among international students, socioeconomic resources and behavioural factors may play a more prominent role in shaping dietary diversity outcomes. Universities and policymakers should prioritise equitable food access, culturally inclusive meal services, and ongoing monitoring of student food security to promote nutrition equity and academic well-being. Full article

Background: Childhood and adolescence represent a critical period for shaping long-term dietary habits, including whole grain consumption, which remains low despite well-documented health benefits. Objective: This cross-sectional study (November–December 2024) examined Slovenian adolescents’ attitudes toward whole-grain foods in the context of organized school meals. Methods: Participants aged 10–12 years and 14–19 years (N = 501; mean age 15.6 ± 2.6) completed an online questionnaire assessing knowledge, self-reported consumption frequency, preferences, motivational factors, and food neophobia using the translated Italian Child Food Neophobia Scale (ICFNS). Based on ICFNS scores, participants were classified as low (≤17), medium (18–24), or high (≥25) in food neophobia. Results: Older adolescents demonstrated better knowledge of whole-grain health benefits; however, greater knowledge was not associated with higher self-reported consumption. Food neophobia was strongly associated with lower consumption frequency and reduced willingness to try whole-grain foods, including whole-grain bread, oatmeal, buckwheat porridge and brown rice. Across all groups, taste was the most consistent motivator for trying whole-grain foods. Older adolescents prioritized health and appearance as key reasons for eating more whole grain foods. Conclusions: Findings suggest that improving taste, increasing exposure, and leveraging institutional settings such as schools, where availability, preparation, and social cues can be managed, may be effective in promoting whole-grain food consumption. Full article

Background: Nutritional psychoeducation is a core component of multidisciplinary treatment for anorexia nervosa, yet evidence on its association with changes in eating behavior beyond weight outcomes remains limited. Methods: This pre–post observational study included 45 patients with anorexia nervosa attending a Day Hospital program who participated in a structured, group-based nutritional psychoeducational intervention as part of standard multidisciplinary care. Nutritional knowledge, dietary rules, eating behaviors, food group exposure assessed by a Food Frequency Questionnaire (FFQ), and body mass index (BMI) were evaluated before and after the intervention. Pre–post changes were examined using paired statistical tests with Holm correction. Associations between changes in cognitive–nutritional variables and eating behavior were explored using correlations and multiple linear regression models. Results: Significant pre–post improvements were observed in nutritional knowledge and reductions in rigid dietary rules. Eating behavior showed specific changes, with increased exposure to carbohydrate- and fat-containing foods, as well as improved meal adequacy. BMI increased during the observation period, consistent with expected outcomes of Day Hospital treatment. Changes in nutrient-related knowledge were positively associated with changes in dietary fat exposure, independent of baseline BMI and changes in dietary rules, whereas no comparable association was observed for carbohydrate exposure. Conclusions: In this Day Hospital sample, participation in a group-based nutritional psychoeducational program within a multidisciplinary treatment context was associated with specific changes in eating behavior alongside cognitive–nutritional changes and weight gain. The observed association between nutrient-related knowledge and dietary fat exposure may suggest the relevance of assessing food-specific behaviors and cognitive–nutritional processes as complementary outcomes during treatment for anorexia nervosa. Full article

(1) Background: Nutrition research in cancer care has largely focused on disease prevention and management, overlooking the importance of food literacy. Culinary cancer care programs may address this gap by facilitating the practical application of nutrition through culinary skills, fostering social connections over nutrient-dense meals, and supporting individuals during periods of physical and social vulnerability. The Not-Just-Supper Club (NJSC) at Gilda’s Club Toronto (GT) is a community-based culinary cancer care program delivering evidence-based, plant-forward meals. The objectives of this study were to examine how NJSC supports its members and to provide recommendations to inform future models of culinary cancer care programs. (2) Methods: An explanatory sequential mixed methods design was used. Participants completed a modified food frequency questionnaire (FFQ) assessing major protein food groups since joining NJSC. Semi-structured interviews explored perceived dietary changes, food literacy, and social engagement. Associations between duration of participation and protein food intake were examined using multivariable-adjusted linear regression models. Interview field notes and transcripts were coded in NVivo 12 and thematically analyzed. (3) Results: Among 41 participants, 36 (88%) were female and 17 (41%) were of White ethnicity. A total of 38 (93%) participants reported that NJSC had a positive impact on their lives, and 27 (66%) reported positive changes in eating habits. In multivariable-adjusted analyses, longer participation in NJSC was associated with higher nut consumption (β = 0.49 servings/day per year; 95% CI, 0.02–0.96). Interviews were completed by 40 participants. Seven themes described program support across psychosocial domains (social network; social support; emotional support and mental health; impact on health) and practical nutritional domains (improved food literacy and skills; food decisions; inclusion of plant-based foods). Participants described applying program knowledge at home and perceived improvements in well-being and cancer-related symptoms. (4) Conclusions: NJSC was perceived by members as beneficial across psychosocial and nutritional domains and supported food literacy and plant-forward dietary choices. These findings contribute to our understanding of how culinary cancer care programs can complement existing cancer support services and provide insights for designing future programs for cancer survivors and their support networks. Full article

Background/Objectives: Obesity and type 2 diabetes are increasingly common among patients undergoing hip and knee arthroplasty and are associated with higher risks of prosthetic joint infection, impaired wound healing, and prolonged hospitalisation. Dietary carbohydrate restriction has demonstrated benefits in glycemic control and weight reduction, but its feasibility and safety in the perioperative arthroplasty population remain underexplored. This pilot study evaluated the safety, feasibility, and short-term metabolic effects of a low-carbohydrate diet supported by WhatsApp-based meal photo-logging in patients undergoing total hip or knee arthroplasty. Methods: A retrospective cohort analysis was performed on 43 patients enrolled in a carbohydrate-restricted dietary programme between 2021 and 2024. Patients submitted photographs of all meals via WhatsApp with a minimum contact frequency of four times daily, enabling real-time feedback and medication adjustment. Anthropometric and metabolic parameters, including weight, BMI, HbA1c, renal function, and lipid profile, were assessed before and after the intervention. Results: Participants (mean age 69.12 ± 7.51 years) demonstrated significant improvement across several metabolic markers. Mean weight decreased by 5.74 kg (p < 0.001), BMI by 2.26 kg/m² (p < 0.001), and HbA1c by 0.72% (p < 0.001). No episodes of severe hypoglycaemia or perioperative discharge delays related to glycemic instability were observed. Renal function remained stable, with no significant change in eGFR (p = 0.442). Among patients with available lipid data (n = 14), LDL-cholesterol and total cholesterol increased, while triglycerides showed a non-significant downward trend. Conclusions: A low-carbohydrate diet combined with high-frequency digital monitoring appears feasible and safe, achieving meaningful short-term improvements in weight and glycemic control without adverse renal or hypoglycemic events. The lipid changes observed, however, warrant cautious interpretation. These findings are hypothesis-generating, and larger prospective studies are needed to confirm the clinical impact of this approach and its relevance to perioperative optimisation. Full article

Background and objective: Depression is the most common mental health problem in women during pregnancy, associated with psychological, social, and medical factors characteristic of this stage. However, a lack of knowledge and limited attention to this condition can aggravate its consequences and restrict access to appropriate treatment. This research seeks to fill a gap in the scientific literature by exploring the association between eating habits and dietary diversity with depressive symptomatology in a group with high psychosocial vulnerability: pregnant adolescents. Material and methods: A cross-sectional analytical study was conducted with a sample of 344 pregnant adolescents attending prenatal care at the National Institute of Perinatology (INPer), a tertiary care center. Non-probabilistic sampling was used for recruitment. Relevant information was collected using a pre-validated structured questionnaire administered via interview. Depressive symptomatology was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a score of ≥12 considered indicative of a higher risk of depression. Eating habits were evaluated based on meal omission, activities performed during meals, and dietary diversity, comparing them with national recommendations. Food group consumption was assessed using a semi-quantitative Food Frequency Questionnaire (FFQ). Robust variance Poisson regression models were employed to evaluate the independent association between undesirable eating habits, inadequate food group intake, and the presence of depressive symptomatology. Results: A significant association was observed between the presence of depressive symptoms (EPDS ≥ 12) and the omission of main meals. Specifically, skipping breakfast was associated with a higher prevalence of EPDS scores ≥ 12 (aPR = 1.55; 95% CI: 1.10–2.19; p = 0.013). Similarly, adolescents who skipped lunch showed a higher prevalence of depressive symptomatology compared to those who did not (aPR = 2.02; 95% CI: 1.11–3.68; p = 0.022). Regarding food groups, only insufficient intake of milk and dairy products was significantly associated with the presence of depressive symptoms (aPR: 1.78; 95% CI: 1.16–2.73; p = 0.008). Conclusions: This cross-sectional study found a significant association between breakfast skipping, distraction while eating, and inadequate dairy intake with a higher prevalence of depressive symptoms in socially vulnerable pregnant adolescents treated at a tertiary care center. However, due to the study’s design, causality or the direction of the relationship cannot be established (it could be bidirectional), and it cannot be affirmed that modifying the diet will necessarily reduce depression. Furthermore, the results are not generalizable to all pregnant adolescents, and future research (longitudinal or interventional) is needed to better understand these associations before developing specific dietary interventions. Full article