Search Results (4,447)

Purpose: Anemia remains a major public health concern among vulnerable rural adolescent girls in many countries, including India. This study aimed to assess the prevalence of anemia, nutritional status, and anemia-related knowledge, attitudes, and practices (KAP) among school-going rural adolescent girls, along with predictors of KAP score, complemented by stakeholder perspectives. Methods: A mixed-methods cross-sectional study was conducted among 553 school-going adolescent girls aged 14–19, selected through a multi-stage stratified random sampling technique from three rural districts of Andhra Pradesh, India. Quantitative data were collected using a structured questionnaire assessing KAP, anthropometric measurements to collect Body Mass Index (BMI) and middle upper arm circumference (MUAC), dietary assessments using a dietary diversity score, and hemoglobin estimation using standardized procedures. Qualitative insights were obtained through focus group discussions (FGDs) with teachers, parents, frontline health workers, and community leaders and analyzed thematically. Logistic regression analysis was performed to identify predictors of KAP. Results: The prevalence of anemia among the participants was 55.3%, and 30.7% were underweight. Although over half of the girls demonstrated adequate knowledge of anemia, only 39.6% reported good anemia-preventive practices, indicating a significant gap between knowledge and practice. Dietary scores indicated micronutrient-deficient diet consumption by participants (36.2%), which might be contributing to anemia. Multivariable analysis revealed that maternal education, hemoglobin status, diet patterns, and type of school attended were significantly associated with KAP scores. Qualitative findings highlighted challenges related to health-seeking behavior, cultural misconceptions, gaps in awareness and implementation of existing adolescent health programs. Conclusions: Anemia remains highly prevalent among rural school-going adolescent girls in Andhra Pradesh, with suboptimal anemia-preventive practices despite moderate levels of knowledge. Strengthening school-based nutritional education, improving dietary diversity, and enhancing the reach and effectiveness of adolescent health programs through community engagement may help combat anemia. Full article

Rice (Oryza sativa L.) grain quality is a critical determinant of market value, consumer acceptance, and nutritional security. This multifaceted trait is governed by the dynamic interaction of genotype (G), environment (E), and management practices (M). In this review, we synthesize recent advances in understanding these multifaceted determinants. We first delineate the genetic architecture, emphasizing key genes and quantitative trait loci (QTLs) such as Wx, ALK, Chalk5, and the GS3/GW families, which control starch composition, gelatinization temperature, chalkiness, and grain dimensions, forming the foundational blueprint for quality potential. We examine how this genetic potential is influenced by environmental factors, focusing on the detrimental impacts of abiotic stresses, particularly high temperatures during grain filling and drought, which impair milling yield, increase chalkiness, and modify starch and protein profiles. Furthermore, we discuss how optimized agronomic strategies—including precision water management (e.g., alternate wetting and drying), balanced nitrogen fertilization, and targeted micronutrient (e.g., silicon) application—can mitigate these adverse effects and potentially improve specific quality parameters. Post-harvest handling is identified as the final determinant of product quality. We conclude that achieving high and stable rice quality under climate variability requires an integrated G × E × M approach. Prospects include next-generation breeding for climate-resilient quality, precision agronomy guided by real-time sensing, synergistic soil health management, and the integration of systems biology with digital agriculture to design sustainable, high-quality rice production systems. Full article

Manganese (Mn) is an essential micronutrient required for plant growth, photosynthesis and metabolic regulation. Its importance is related to the involvement in several metabolic processes that ensure proper cellular function and balanced plant development throughout the production cycle. In plants, Mn is absorbed predominantly as Mn²⁺, and its availability is strongly influenced by soil pH, aeration, and other mineral nutrients in the soil solution. After uptake by roots, Mn is translocated to the shoot, accumulating primarily in metabolically active organs such as stems, young leaves and flowers. Although Mn exhibits limited mobility in the phloem, adequate concentrations are necessary to sustain both vegetative development and reproductive growth. Adequate Mn concentration is directly reflected in fruit development, as well-nourished plants show improved flowering, greater assimilate translocation capacity, and better fruit filling, thereby positively influencing yield and quality. However, Mn deficiency is common in alkaline soils or soils with high organic matter, causing interveinal chlorosis in young leaves, reduced growth, and lower biomass production. Under prolonged conditions, deficiency leads to less vigorous plants with reduced metabolic efficiency. Conversely, Mn toxicity, typically associated with acidic and poorly drained soils, restricts root development and induces nutritional imbalances with other elements, such as calcium, magnesium, and iron. Therefore, proper Mn management is essential to ensure nutritional balance and optimal performance of agricultural crops. Overall, this review synthesizes advances in Mn transport, cellular compartmentalization, and metabolic regulation, emphasizing how Mn interacts with other mineral nutrients to influence plant physiology. Attention is given to the integration of Mn with redox networks, photosynthetic regulation, and reproductive development. By linking transport mechanisms with physiological outcomes, this review identifies key patterns governing Mn homeostasis and highlights implications for crop nutrition and sustainable nutrient management. Full article

The ketogenic diet (KD) is a critical, evidence-based intervention within medical nutrition therapy for managing neurological disorders. In this article, we reviewed the published research on the efficacy of the ketogenic diet and its variations in treating epilepsy, particularly for patients unresponsive to anti-epileptic drugs. The literature review was performed on PubMed between 2022 and 2025. The review of clinical studies across various age groups reveals that, while the KD is effective for both focal and generalized seizures, infants often achieve higher rates of seizure freedom compared to adults, potentially due to better dietary compliance. Despite its success, the restrictive nature of the diet presents significant challenges for individuals suffering from epilepsy. The key challenges that reduce compliance over time include side effects, such as gastrointestinal issues, potential for malnutrition, and a high risk of micronutrient deficiencies. The role of the registered dietitian is paramount in this interdisciplinary approach, ensuring personalized education by monitoring growth and adjusting nutritional plans to optimize health outcomes for children unresponsive to anti-epileptic drugs. Ultimately, integrating MNT with traditional pharmacological or surgical treatments offers the most promising path for significant seizure reduction and improved quality of life for epileptic patients. Full article

Fenton-based processes are widely used advanced oxidation methods that are known for degrading persistent pollutants. However, these techniques often generate significant amounts of iron-containing sludge, which poses environmental disposal challenges due to its complex composition. Furthermore, the sludge produced by the Fenton process contains a high content of Fe(III) compounds, which can serve as an iron source to stimulate dissimilatory iron reduction (DIR), enhancing the performance of anaerobic digestion. Based on the characterization results from a previous study, this work investigated the use of the ferrous precipitate generated by the electrochemical peroxidation process applied to tannery wastewater treatment as an additive to enhance volatile fatty acids (VFAs) production during dark fermentation. The performance of ferrous precipitate (R-Fe₃O₄) was compared to that of conventional magnetite (Fe₃O₄) during dark fermentation under high organic loading conditions, emphasizing their potential to enhance hydrolysis efficiency and VFAs production yields, while promoting sustainable resource recovery and reuse within a circular bioeconomy framework. The results showed that the addition of both Fe₃O₄ and R-Fe₃O₄ significantly increased the VFAs yields, with a predominance of long-chain fatty acids. The presence of CaCO₃ in the ferrous precipitate contributed to maintaining a stable pH environment, supporting microbial activity and enhancing the hydrolysis of soluble compounds. Moreover, the availability of essential micronutrients within the ferrous precipitate favored greater microbial diversity. Consequently, the addition of R-Fe₃O₄ promoted VFAs production, even at higher organic loading rates, suggesting a promising application of Fenton-based by-products as functional additives to improve the economic and environmental performance of the dark fermentation process. Full article

Background: Diet quality and food processing patterns are increasingly recognized as important determinants of Crohn’s disease (CD) risk and disease outcomes; however, direct comparisons with healthy populations using integrated nutrient- and processing-based frameworks remain limited. Therefore, we aim to quantify ultra-processed food (UPF) consumption using the NOVA classification, compare UPF intake between CD patients and healthy controls, and assess its association with diet quality indices. Methods: Baseline dietary intake data were analyzed from two randomized controlled trial cohorts: adults with mild to moderately active CD enrolled in the Crohn’s Disease Therapeutic Dietary Intervention (CD-TDI) trial (n = 64; NCT04596566), and healthy adults participating in the MAPMed study (n = 33, NCT06765369). Dietary intake was assessed using two non-consecutive 24 h recalls collected with the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24^®). Energy-normalized macronutrient and micronutrient intakes were compared with Dietary Reference Intakes (DRIs). Overall diet quality was evaluated using the Healthy Eating Index-2020 (HEI-2015), Alternate Mediterranean Diet score (aMED), and Dietary Inflammatory Index (DII). Foods were classified according to the NOVA food processing system to estimate total and proportional energy intake from UPFs (NOVA group 4). Results: Both the CD cohort and healthy cohort exhibited suboptimal dietary patterns, with HEI scores indicating a need for improvement, low adherence to the Mediterranean diet (aMED), and neutral-to-pro-inflammatory DII scores, with no significant between-group differences (all p > 0.05). Although total energy intake differed between groups (p = 0.04), the proportion of energy derived from UPFs (NOVA group 4) accounted for half of the total intake in both cohorts (51.3–51.8%; p = 0.55). Higher UPF intake was associated with lower HEI and aMED scores and higher DII scores. Conclusions: In this study, there were no significant differences in the dietary patterns in those with CD compared to healthy controls. The high contribution of UPFs observed in both cohorts underscores widespread suboptimal dietary quality and highlights the utility of NOVA-based food processing measures as complementary to nutrient-based assessments for understanding diet-related inflammatory burden in CD. Full article

The menstrual cycle represents a dynamic infradian rhythm characterized by coordinated fluctuations in ovarian steroids that extend beyond reproductive function and influence systemic metabolism. This narrative review synthesizes current evidence on how menstrual cycle phase modulates energy balance, macronutrient metabolism, micronutrient handling, and responses to dietary bioactive compounds. Across phases, small-to-moderate but consistent differences emerge in energy intake, resting energy expenditure, substrate utilization, and protein turnover, with a tendency toward increased energy intake and lipid oxidation during the mid-luteal phase compared with the early follicular and peri-ovulatory phases. Emerging metabolomics data further reveal coordinated cyclical variation in amino acids, B vitamins, and lipid species, suggesting temporally sensitive windows in which low energy availability or micronutrient insufficiency may more readily impair performance, recovery, or symptom burden. Importantly, menstrual cycle-related metabolic variability reflects not only estradiol and progesterone oscillations but also integrated adaptations across the hypothalamic–pituitary–adrenal axis, autonomic nervous system, immune signaling, and gut microbiota. These interconnected systems contribute to inter- and intra-individual heterogeneity in metabolic phenotype. From a clinical and applied perspective, the evidence supports “cycle-aware” but non-dogmatic nutritional strategies, particularly in contexts of metabolic dysfunction, high training loads, or reproductive disorders. Future research should systematically verify cycle phase, incorporate multi-system biomarkers, and adopt sex-specific analytical frameworks to improve translational relevance. Recognizing the menstrual cycle as a biologically meaningful metabolic variable may enhance precision nutrition, exercise prescription, and metabolic risk assessment in women. Full article

Objective: Nutrition is a key determinant of women’s health across all life stages. Clinical practice remains heterogeneous because of lack of evidence and non-homogeneous guidelines. Despite growing research on micronutrient supplementation, skeptical opinions persist around universal versus individualized approaches, optimal dosages, and life-stage-specific recommendations. Material and methods: This is a modified Delphi process conducted under the supervision of the Italian Association of University Gynecologists and Obstetricians (AGUI). Thirteen Italian experts in gynecology and obstetrics completed two rounds of anonymous online surveys (September–November 2025). The questionnaire, developed through a scoping review, covered six domains: pre-/periconception, pregnancy, postpartum, routine supplementation in non-pregnant women, nutrition in gynecological conditions, and menopause. Consensus was defined as ≥75% agreement on a 10-point Likert scale. Quantitative data were summarized descriptively, and qualitative comments contextualized findings. Results: Experts strongly supported personalized nutritional strategies across all life stages. Consensus was reached on individualized micronutrient supplementation in the preconception period and on the prescription of active folates for women undergoing assisted reproduction. In pregnancy, agreement emerged for universal DHA supplementation (200–300 mg/day); however, universal vitamin D supplementation lacked consensus except in gestational diabetes. In the postpartum period, iron supplementation for non-breastfeeding women reached consensus, while micronutrient recommendations for breastfeeding women remained uncertain. Strong agreement supported personalized dietary approaches for PCOS, endometriosis, and gestational diabetes, including inositol use, while evidence for interventions in severe premenstrual syndrome remained insufficiently supported. In menopause, consensus was reached for macronutrient adjustments and universal calcium and vitamin D supplementation. Conclusions: This Delphi consensus highlights shared expert perspectives on nutritional care in women and identifies key evidence gaps, particularly regarding vitamin D in physiological pregnancy, postpartum micronutrient needs during breastfeeding, and nutritional strategies for premenstrual disorders. Unified life-course guidelines and future research on standardized nutritional assessments are necessary for nutritional approach management. Full article

Micronutrient deficiencies in human diets, often exacerbated by soil degradation, pose a significant global health challenge. Glacial flour, fine sediments produced by glacial erosion, may offer a sustainable, low-cost solution to improve soil fertility and enhance micronutrient availability in crops. This study evaluates the potential of glacial flour soil amendments from glaciers with two contrasting lithologies—basaltic Sólheimajökull (Iceland) and metasedimentary Chhota Shigri (Himalaya)—to enrich soybeans (Glycine max var. Black Jet) with essential nutrients while assessing the risk associated with potentially toxic elements. In a controlled glasshouse experiment, soybeans were grown in artificial soils amended with five doses of glacial flour (0.5–20 T ha⁻¹) and analysed for 18 elements. Results demonstrated enhanced uptake of key nutrients such as Zn, Fe, Mo, and Se, particularly in Icelandic glacial flour treatments, supporting the potential for crop biofortification. However, Himalayan flour led to arsenic (As) accumulation at higher doses, exceeding food safety limits. Multivariate clustering revealed two distinct element uptake behaviours: oxyanion-mediated and mimicking elements (Mo, Se, Sr, As) and those driven by plant demand (macronutrients, Fe, Mn, Zn). These findings highlight glacial flour’s potential for nutrient enrichment but also of potentially toxic elements, underscoring the need for source-specific screening to ensure safe agricultural application in deglaciating regions. Full article

Type 2 Diabetes Mellitus (T2DM) is a complex metabolic disorder characterized by insulin resistance, chronic low-grade inflammation, and progressive metabolic dysfunction affecting multiple organs. This review explores the molecular and physiological mechanisms underlying T2DM, emphasizing the role of intracellular metabolic signaling pathways, mitochondrial function, and inter-organ communication in the development and progression of metabolic dysregulation. Particular attention is given to key regulatory pathways such as AMP-activated protein kinase (AMPK) and the mechanistic target of rapamycin (mTOR), which play central roles in cellular energy sensing, glucose metabolism, and lipid homeostasis. Dysregulation of these pathways contributes to impaired insulin signaling, mitochondrial dysfunction, oxidative stress, and altered adipogenesis, all of which are critical factors in the pathophysiology of T2DM. In addition, growing evidence highlights the importance of metabolic crosstalk between skeletal muscle, adipose tissue, liver, pancreas, and the gut microbiota through signaling molecules including adipokines, myokines, hepatokines, and gut-derived metabolites. These inter-organ networks influence systemic inflammation, metabolic flexibility, and glucose homeostasis. Lifestyle factors such as physical activity, nutritional patterns, and micronutrient status have also been shown to modulate these molecular pathways, improving mitochondrial function and insulin sensitivity while reducing inflammatory signaling. Despite significant advances in understanding the molecular basis of T2DM, important challenges remain, including heterogeneity in disease progression and variability in individual metabolic responses. In conclusion, T2DM should be understood as a multisystem metabolic disorder driven by complex interactions between molecular signaling pathways and systemic metabolic regulation. Future research integrating molecular mechanisms with clinical and lifestyle interventions may help develop more effective strategies for prevention and treatment. Full article

The reciprocal relationship between genes and nutrients, known as nutrigenetics and nutrigenomics, has been established in many studies. However, current investigations of maternal and neonatal nutrition using a precision nutrition approach focused on genomics are limited, especially in the Middle East and North Africa (MENA) region. This review aims to summarize the impacts of the dietary micronutrients, folic acid, thiamine, and cobalamin on optimal health outcomes during pregnancy, fetal development, lactation, and infant growth. In this review, the roles of folic acid, thiamine, and cobalamin are discussed in the context of various aspects of pregnancy, such as preconception, fetal development, and lactation, highlighting how genetic events occurring during developmental periods can have consequential impacts on health outcomes later in life. Deficiency rates and related health consequences as well as the prevalence of genetic mutations related to these nutrients of interest in the MENA region are also elaborated on. How to advance knowledge and applications of precision nutrition, how genes interact with the neurochemical changes during pregnancy, and how this interaction impacts maternal eating behaviors, and consequently fetal development and infant and child growth and health, should be further explored in future studies. This includes taking advantage of cutting-edge technologies and the role of artificial intelligence in this endeavor. Full article

Background: Micronutrient deficiencies (MD) are highly prevalent among candidates for bariatric surgery (BS) and are associated with adverse perioperative and postoperative outcomes. Although guidelines recommend systematic preoperative screening and correction, conventional targeted supplementation (CTS) often requires multiple products, potentially limiting adherence and delaying surgical readiness. Bariatric-specific multivitamins (BSM) may simplify nutritional management, but their real-world effectiveness for preoperative correction of multiple MD remains insufficiently investigated. Objective: To compare the effectiveness, efficiency, and adherence of a BSM versus CTS for preoperative correction of multiple MD in BS candidates. Methods: This retrospective multicenter cohort study included 1560 adults with obesity evaluated for BS between 2020 and 2024 across three Italian bariatric centers. The primary efficacy analysis was restricted to patients presenting with ≥3 laboratory-confirmed MD at baseline. Patients treated between 2020 and 2022 received individualized CTS using multiple products, whereas those treated between 2023 and 2024 received a single BSM. Biochemical follow-up was scheduled at 4 and 8 weeks. The primary outcome was the achievement of complete biochemical correction of all baseline deficiencies at the predefined 4-week follow-up assessment (composite endpoint). Secondary outcomes included supplementation burden and self-reported adherence. Early correction rates were compared using absolute risk differences and risk ratios; adjusted associations were evaluated using multivariable regression models including center and baseline deficiency burden. As a supplementary analysis, the patient-level proportion of baseline deficiencies corrected at 4 weeks was also evaluated. Results: Among patients with ≥3 baseline deficiencies (n = 216), complete biochemical correction at 4 weeks was achieved in 55/134 patients (41.0%) in the BSM group and in 13/82 patients (15.9%) in the CTS group, corresponding to an absolute risk difference of 25.2 percentage points (95% CI 7.8–40.0) and a risk ratio of 2.59 (95% CI 1.51–4.44). In adjusted analyses accounting for center and baseline deficiency pattern, BSM use remained independently associated with early complete correction (adjusted absolute risk difference 26.3 percentage points; adjusted risk ratio 2.69). Sensitivity analyses restricting follow-up timing and excluding early calendar periods yielded consistent results. The mean proportion of baseline deficiencies corrected per patient at 4 weeks was higher in the BSM group compared with CTS (0.74 ± 0.25 vs. 0.54 ± 0.30). Compared with CTS, BSM was associated with lower supplementation burden (1 vs. 3.5 supplements on average) and higher adherence (92% vs. 70%). Conclusions: In a real-world multicenter cohort of BS candidates with ≥3 baseline MD, a simplified preoperative supplementation strategy based on a BSM was associated with a significantly higher probability of complete biochemical correction at 4 weeks, lower supplementation burden, and higher reported adherence compared with CTS. Although complete correction was not universal at 4 weeks, BSM significantly increased the likelihood of achieving early multi-deficiency normalization. Given the non-concurrent observational design, these findings should be interpreted as hypothesis-generating and warrant confirmation in prospective studies with concurrent cohorts. Full article

Background: Many countries in sub-Saharan Africa are at risk of inadequate calcium intake, yet no data exist for vulnerable population groups in Madagascar. We aimed to assess daily calcium intake, the major contributing food sources, and the prevalence of inadequate intake in young children, adolescents, and women of reproductive age. Methods: The 2024 National Micronutrient Survey used a two-stage probabilistic design across all 23 regions. The daily calcium intake was estimated using a food frequency questionnaire that focused on calcium-rich foods that are commonly consumed in Madagascar and the calcium concentration measured in drinking water. Results: Calcium intake was low across all population groups, averaging 200–300 mg/d in adolescents and women and below 180 mg/d in young children. The prevalence of inadequate intake exceeded 96% in every population group. While calcium intake increased with increasing household wealth in children, the opposite pattern was observed for adolescents and women, whose intake decreased with increasing wealth. The main contributors to calcium intake were cassava leaves, cassava roots, small fresh and dried fish eaten with bones, drinking water across all population groups, and breastmilk in young children. Conclusions: The calcium intake is low throughout Madagascar and across all demographic groups. Strategies to improve intake are urgently needed and should include promoting continued breastfeeding and the consumption of calcium-rich, locally available, affordable foods such as small fish eaten with bones and leafy green vegetables, alongside a consideration of wheat flour fortified with calcium. Full article

Yucca decipiens is a native species from arid and semi-arid regions with emerging nutritional and biotechnological potential. This study evaluated its proximate composition, elemental profile determined by inductively coupled plasma mass spectrometry (ICP-MS), and growth performance under nursery conditions. Proximate analysis revealed a high dietary fiber content in leaves (58.93%) and higher carbohydrate levels in stems (28.83%). Free amino acid content was significantly higher in stems (2.75 g histidine equivalents kg⁻¹) than in leaves (1.76 g kg⁻¹). Multi-elemental profiling (63 elements) showed organ-specific accumulation patterns, with essential macro- and micronutrients predominantly concentrated in leaves, including potassium (28,334 ppm) and calcium (15,345 ppm), while iron was the most abundant trace element in stems (1253 ppm). Principal component analysis (PCA) revealed clear organ-specific mineral partitioning between leaves and stems, indicating differentiated physiological roles and potential selective biomass utilization. Growth assessment conducted over a two-year period demonstrated steady biomass accumulation and good adaptive performance under nursery conditions. Overall, the results highlight the emerging nutritional and agroindustrial relevance of Yucca decipiens for applications in semi-arid environments. Full article

The valorization of industrial waste in agriculture represents a key strategy within the circular economy framework. In this context, the present study aimed to assess the feasibility and potential of fertilizers derived from black mass, a by-product of alkaline battery recycling, as alternative sources of Zn and Mn in citrus cultivation, evaluating their effects on fruit quality and food safety. The experiment was conducted in Pedreguer (Alicante, Spain) in ‘Navelina’ cultivar using Carrizo and C-35 rootstocks, comparing conventional fertilization with black mass-based formulations applied as sulfates (BMSs) and lignosulfonates (BMLSs). The results showed that the evaluated micronutrient sources significantly increased foliar Zn concentrations up to 17.9 mg·kg⁻¹ and Mn concentrations up to 28.1 mg·kg⁻¹, values markedly higher than those observed in the Control treatment (15.20 mg·kg⁻¹ Zn and 11.5 mg·kg⁻¹ Mn). No adverse effects on yield or fruit quality were detected: Average fruit weight remained close to 200 g per fruit, and the proportion of non-marketable fruit did not exceed 2% in any treatment. Regarding food safety, Pb, Cr, and Ni concentrations in pulp and peel were below the maximum levels established by European Union regulations, with maximum values of 0.02 mg·kg⁻¹ for Ni and 0.04 mg·kg⁻¹ for Pb on a dry matter basis, while Cd, Co, and Hg were not detected. Overall, black mass-derived fertilizers enhanced Zn and Mn availability in plants without compromising plant physiology or fruit quality and maintained safe levels of heavy metals. These results support their use as a sustainable alternative for mineral fertilization in citrus orchards and reinforce their contribution to reducing the consumption of virgin raw materials and advancing toward more circular agricultural systems. Full article