Search Results (151)

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

Background/Objectives: Excessive social media usage in the current times and high rates of food advertising can impact the health status of individuals by increasing food cues related to perceived hunger and, thus, dietary behaviour. This study examined the association between social media usage patterns, food-related advertising, and dietary choices among Gen Z individuals. Methods: A cross-sectional study was carried out amongst 314 young adults between the ages of 18 and 25 in Surat city, Gujarat. Data was collected for social media usage, the most used platforms, preferred content, and eating patterns. Anthropometric measurements (height and weight) were also recorded. Perceived hunger responses to 12 social media-based food images were assessed using a ten-point Visual Analogue Scale (VAS). Statistical analyses were performed using SPSS (version 26.0), with the significance level set at p < 0.05. Results: YouTube and Instagram were the most used social media apps. There were no significant differences observed between the BMI of participants using social media for 2 h a day and those using it 3+ hours a day. However, a significant association between the BMI of those who viewed advertisements for ready-to-eat foods (p = 0.004) and the BMI of those who viewed advertisements for food delivery platforms (p = 0.001) was seen. A significant difference between usage of Pinterest (p = 0.02), Instagram (p = 0.047), and BMI was also found. Conclusions: Social media marketing and food content are shaping the dietary choices of young adults, and more studies need to be conducted in Pan India to understand the reasons. Such evidence will be crucial for guiding nutrition policies, digital marketing regulations, and youth-focused awareness programmes. Full article

Background/Objectives: Traditional dietary monitoring methods such as 24 h recalls rely on self-report, leading to recall bias and underreporting. Similarly, dietary control approaches, including portion control and calorie restriction, depend on user accuracy and consistency. Augmented reality (AR) offers a promising alternative for improving dietary monitoring and control by enhancing engagement, feedback accuracy, and user learning. This systematic review aimed to examine how AR technologies are implemented to support dietary monitoring and control and to evaluate their usability and effectiveness among adults. Methods: A systematic search of PubMed, CINAHL, and Embase identified studies published between 2000 and 2025 that evaluated augmented reality for dietary monitoring and control among adults. Eligible studies included peer-reviewed and gray literature in English. Data extraction focused on study design, AR system type, usability, and effectiveness outcomes. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized controlled trials and ROBINS-I for non-randomized studies. Results: Thirteen studies met inclusion criteria. Since the evidence based was heterogeneous in design, outcomes, and measurement, findings were synthesized qualitatively rather than pooled. Most studies utilized smartphone-based AR systems for portion size estimation, nutrition education, and behavior modification. Usability and satisfaction varied by study: One study found that 80% of participants (N = 15) were satisfied or extremely satisfied with the AR tool. Another reported that 100% of users (N = 26) rated the app easy to use, and a separate study observed a 72.5% agreement rate on ease of use among participants (N = 40). Several studies also examined portion size estimation, with one reporting a 12.2% improvement in estimation accuracy and another showing −6% estimation, though a 12.7% overestimation in energy intake persisted. Additional outcomes related to behavior, dietary knowledge, and physiological or psychological effects were also identified across the review. Common limitations included difficulty aligning markers, overestimation of amorphous foods, and short intervention durations. Despite these promising findings, the existing evidence is limited by small sample sizes, heterogeneity in intervention and device design, short study durations, and variability in usability and accuracy measures. The limitations of this review warrant cautious interpretation of findings. Conclusions: AR technologies show promise for improving dietary monitoring and control by enhancing accuracy, engagement, and behavior change. Future research should focus on longitudinal designs, diverse populations, and integration with multimodal sensors and artificial intelligence. Full article

Each year, over 1 million people in the United States die from diabetes and cardiovascular diseases (CVDs). These largely preventable chronic conditions also create a financial burden on patients, payers, and healthcare systems. The popularity of GLP-1-based management of cardiometabolic conditions can escalate healthcare spending, while incentivizing digitization of semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro), and others using the “prescription drug use-related software” (PDURS) framework. In this article, we highlight opportunities to advance digital-first interventions and metformin-enhanced digital therapeutics (DTx) for the primary prevention of diabetes and CVDs. Metformin is a low-cost antidiabetic medication that is effective in preventing diabetes and cardiovascular adverse events. Concurrently, digital health technologies for managing chronic conditions, e.g., Dario Health, Omada Health, and WellDoc, enable digital-first and drug + digital combination therapies for prediabetes and those at risk for CVDs. We describe incentives for advancing Affordable Primary Prevention (APP), suggesting that nonprofit healthcare systems, such as Kaiser Permanente, Intermountain Health or Ascension Health, payers such as Cigna and Aetna/CVS Health, or private equity investors can leverage their venture funds to support development of metformin-enhanced DTx. In conclusion, (1) the PDURS framework can accelerate innovation of preventive medicine by bridging precision digital interventions with low-cost generic drugs, and (2) integrating healthy behaviors with pharmacotherapies is essential for the financially sustainable prevention of lifestyle-related chronic diseases. Full article

Background: Adolescence represents a critical period for growth and athletic development, yet young athletes frequently demonstrate significant gaps in nutritional knowledge that can impair performance and long-term health outcomes. Limited research exists on comprehensive nutrition education interventions for adolescent soccer players in North African populations. Objective: To evaluate both general and sports-specific nutritional knowledge among adolescent soccer players from an elite Tunisian club and assess the feasibility of a digital nutrition intervention using mobile application technology. Methods: A cross-sectional survey was conducted between June and August 2024 among 50 male soccer players aged 11–18 years from Étoile du Sahel club in Sousse, Tunisia. Data were collected via a structured questionnaire comprising sections on basic nutrition knowledge, influences on food choices, sports nutrition knowledge and practices, and demographic information. A pilot digital intervention using the FatSecret app was implemented with 8 participants over 4 weeks, involving meal photo uploads and nutritionist feedback. Results: Participants had a mean age of 15.16 ± 1.55 years, with 92% reporting no formal nutrition education. While 90% correctly identified carbohydrates as the primary energy source, only 2% recognized that fat provides the highest energy density. Significant misconceptions existed regarding sports nutrition: 74% incorrectly believed that consuming protein 2–4 h before an event enhances performance, and only 17% knew the recommended pre-event carbohydrate intake. Food choices were primarily influenced by cravings (80%) and sensory appeal rather than health considerations (20%). The digital intervention demonstrated extremely low engagement, with minimal participation in meal photo uploads. Conclusions: This study reveals critical gaps in both general and sports-specific nutritional knowledge among adolescent soccer players in Tunisia, providing important descriptive information about knowledge distribution in this population. While knowledge deficits are substantial, it is important to acknowledge that this cross-sectional assessment documents only knowledge patterns, without measures of actual dietary intake or athletic performance. The persistent misconceptions and the low feasibility of the digital intervention provide important lessons regarding technology-based approaches to nutrition education in this age group, highlighting challenges in sustained engagement that must be addressed in future intervention design. Full article

This study proposed a methodology for obtaining a valid database of food retail establishments and characterized the community food environment, understood as the distribution and type of food outlets, in a Brazilian medium-sized municipality after the collapse of a mining tailings dam. An ecological study was conducted with establishments selling food for home consumption (butcher shops, fish markets; fruit and vegetable specialty markets; large- and small-chain supermarkets; bakeries and local markets) and immediate consumption (bars, snack bars, and restaurants). For home-consumption establishments, data were requested from governments and completed with website/app searches, virtual audits (Google Street View), and on-site audits. For immediate-consumption establishments, only on-site audit was used due to the low quality of the secondary databases. Agreement between databases was assessed with the Kappa statistic. Density (d) was calculated by the area (in km²) of the sampling stratum. Public databases presented low validity (23.0%; Kappa −0.388; p = 1.000), even after virtual auditing (31.4%; Kappa 0.37; p < 0.001). 96 establishments for home consumption and 261 for immediate consumption were identified, with predominance of local markets (35.4%), bars (35.2%), and snack bars (29.1%). The region with the highest density of establishments was the “Other Areas” stratum (d = 4.7 for home-consumption establishments and d = 13.2 for immediate-consumption establishments). Audit proved most effective, especially for small establishments. The lack of governmental databases and the identified food environment should inform municipal policies to promote food and nutrition security and reduce inequalities after the disaster. Full article

Background/Objectives: The increasing use of electronic devices is reshaping lifestyle by offering new avenues for health behavior change. These tools provide to monitor health, fitness, and nutrition, promoting healthier lifestyles to prevent non-communicable diseases (NCDs). This umbrella review (conducted according to PRISMA 2020 guidelines, registered on PROSPERO CRD42024511141) assesses the effectiveness of wearable devices and mobile applications in improving healthy lifestyle behaviors to mitigate the risk of NCDs. Methods: Systematic reviews and meta-analyses (n = 27) focusing on digital tools for health behavior change were analyzed, with emphasis on their integration into daily life and their impact on health outcomes, including body weight, metabolic and anthropometric parameters, and dietary quality. Results and Conclusions: Interventions leveraging gamification, social interaction, and goal-setting (6/27) have shown greater efficacy in improving body-nutrition profile. The integration of eHealth technologies holds transformative potential for preventive healthcare and positive biology. These tools can contribute to healthier lifestyles, extended life expectancy, and reduced healthcare costs, although current limitations exist, including data accuracy, privacy concerns, and sustaining user engagement over time. Full article

Background: Precision nutrition increasingly integrates mobile health (mHealth) and artificial intelligence (AI) tools. However, personalized hydration remains underdeveloped, particularly in accounting for both food- and beverage-derived water intake. Objective: This scoping review maps the existing literature on mHealth applications that incorporate machine learning (ML) or AI for personalized hydration. The focus is on systems that combine dietary (food-based) and fluid (beverage-based) water sources to generate individualized hydration assessments and recommendations. Methods: Following the PRISMA-ScR guidelines, we conducted a structured literature search across three databases (PubMed, Scopus, Web of Science) through March 2025. Studies were included if they addressed AI or ML within mHealth platforms for personalized hydration or nutrition, with an emphasis on systems using both beverage and food intake data. Results: Of the 43 included studies, most examined dietary recommender systems or hydration-focused apps. Few studies used hydration assessments focusing on both food and beverages or employed AI for integrated guidance. Emerging trends include wearable sensors, AR tools, and behavioral modeling. Conclusions: While numerous digital health tools address hydration or nutrition separately, there is a lack of comprehensive systems leveraging AI to guide hydration from both food and beverage sources. Bridging this gap is essential for effective, equitable, and precise hydration interventions. In this direction, we propose a hydration diet recommender system that integrates demographic, anthropometric, psychological, and socioeconomic data to create a truly personalized diet and hydration plan with a holistic approach. Full article

Background: Plant-based diets are associated with reduced risk of chronic diseases and improved health outcomes. However, sustaining dietary changes remains challenging. Digital interventions—including virtual culinary medicine programs, web-based nutrition coaching, SMS and email reminders, mobile application–based self-management, and hybrid community programs—offer promising strategies to support behavior change, enhance cooking skills, and improve dietary adherence. These approaches are relevant for both healthy individuals and those living with chronic conditions. Methods: We conducted a narrative review of studies published between 2000 and 2025 in PubMed/MEDLINE, Scopus, and Web of Science, supplemented with manual searches. Included studies comprised randomized controlled trials, quasi-experimental designs, feasibility studies, and qualitative research. Interventions were categorized by modality (SMS, email, web platforms, mobile apps, virtual culinary programs, and hybrid formats) and population (healthy adults, patients with chronic diseases). Outcomes examined included dietary quality, self-efficacy, psychosocial well-being, and program engagement. Results: Most studies reported improvements in dietary quality, cooking skills, nutrition knowledge, and psychosocial outcomes. Virtual cooking programs enhanced dietary adherence and engagement, particularly among individuals at cardiovascular risk. Digital nutrition education supported behavior change in chronic disease populations, including patients with multiple sclerosis. SMS and email reminders improved self-monitoring and participation rates, while mobile applications facilitated real-time feedback and goal tracking. Hybrid programs combining online and in-person components increased motivation, social support, and long-term adherence. Reported barriers included limited technological access or skills, lack of personalization, and privacy concerns. Conclusions: Virtual culinary medicine programs and other digital microinterventions—including SMS, email, web, mobile, and hybrid formats—are effective tools to promote plant-based diets. Future interventions should focus on personalized, accessible, and hybrid strategies, with attention to underserved populations, to maximize engagement and sustain long-term dietary change. Full article

Background: Digital transformation is reshaping public organizations worldwide, yet in low-resource contexts, its success is constrained by weak infrastructure and governance. In India, programs such as the Ayushman Bharat Digital Mission and the Aspirational Districts Programme rely on meso-level officers who act as key managerial intermediaries, but their organizational challenges remain understudied. Aim: This study examines sub-district health and nutrition officers’ experiences, organizational barriers, and adaptive strategies in implementing digital reforms. Methods: Eight in-depth interviews were conducted with Medical Officers in Charge (MOICs) and Child Development Project Officers (CDPOs) across urban, semi-urban, rural, and flood-prone blocks of Muzaffarpur, Bihar. Data were transcribed, translated, and thematically analyzed using Braun and Clarke’s approach, informed by organizational and technology adoption theories. Results: Officers valued digital tools for transparency and real-time monitoring but faced systemic barriers, including hardware decay, poor connectivity, fragmented platforms, and limited fiscal autonomy. Despite these, they displayed managerial agency through informal infrastructures such as WhatsApp, peer mentoring, and parallel records. COVID-19 accelerated digital use while widening inequities. Conclusions: Meso-level officers are critical enablers of organizational resilience. Their experiences highlight how leadership, governance, and adaptive management shape digital transformation in resource-constrained settings. Full article

Background/Objectives: Coupling mobile health (mHealth) technology with community-based nutrition programs may enhance diet quality in adolescents. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of integrating PortionSize Ed (PSEd), an image-assisted dietary assessment and education app, into the six-week Hawaii Food and Lifeskills for Youth (HI-FLY) curriculum delivered via Supplemental Nutrition Assistance Program Education (SNAP-Ed). Methods: Adolescents (grades 6–8) from two classrooms were cluster-randomized into HI-FLY or HI-FLY + PSEd. Both groups received HI-FLY and completed Youth Questionnaires (YQ) and food records (written or app-based) at Weeks 0 and 7. Feasibility and acceptability were assessed via enrollment, attrition, and User Satisfaction Surveys (USS). Diet quality was measured using Healthy Eating Index-2020 (HEI-2020) scores and analyzed via mixed-effects models. Results: Of 50 students, 42 (84%) enrolled and attrition was minimal (2.4%). The sample was 49% female and 85% at least part Native Hawaiian or Pacific Islander (NHPI). PSEd was acceptable, with average USS scores above the scale midpoint. No significant HEI-2020 changes were observed, though YQ responses indicated improvements in sugary drink intake (p = 0.03) and use of nutrition labels in HI-FLY + PSEd (p = 0.0007). Conclusions: Integrating PSEd into SNAP-Ed was feasible, acceptable, and demonstrated potential healthy behavior change among predominantly NHPI youth in Hawaii. Full article

Background: University students are particularly vulnerable to psychological distress due to the transitional nature of this life phase and increasing academic, social, and financial pressures. Accumulating evidence indicates that lifestyle behaviors—especially nutrition and physical activity—play a critical role in shaping mental health, cognitive functioning, and overall well-being in this population. Methods: The objective of this scoping review was to systematically map the literature on the combined impacts of diet and physical activity on psychological well-being among university students. Following PRISMA-ScR guidelines, an initial search of three major databases (PubMed, Sciencedirect, and Wiley) yielded 718 articles. After a multi-stage screening process, 39 articles of various designs (including cross-sectional, interventional, and review studies) focusing on non-clinical student populations were included. The studies were then thematically analyzed. Results: While most research explored isolated behaviors, a smaller set of integrated studies revealed synergistic effects, reporting enhanced outcomes in mental health and quality of life. Notably, several articles proposed practical strategies—such as app-based tools, structured wellness initiatives, and interdisciplinary educational programs—as effective means to support healthier habits. Conclusions: The evidence strongly suggests that universities should prioritize holistic, multi-component wellness strategies over siloed, single-behavior initiatives. Developing integrated programs that combine nutritional education and physical activity support represents a practical and effective approach to enhance student well-being. Full article

The healthiness of food can become a weakness of food delivery app services. Hence, this research aims to examine the relationships among health risk, fatigue, loyalty, nutrition disclosure, and chatbot information in the context of food delivery apps. In particular, this study investigates the moderating roles of nutrition disclosure and chatbot information on the effect of health risk on fatigue, using information overload as the theoretical underpinning. Data were collected through an online survey on the Clickworker platform, with 364 valid responses from consumers in the U.S. market. This study employed Hayes’s PROCESS Macro Model 7 to test the research hypotheses. The results indicate that loyalty is significantly affected by both health risk and fatigue. Furthermore, the findings demonstrate significant moderating effects of nutrition disclosure and chatbot information on the relationship between health risk and fatigue. This study contributes to the literature by elucidating the associations among the five constructs and additionally provides important managerial implications. Full article

Automated food item recognition and recipe recommendation systems have gained increasing importance in dietary management and culinary applications. Recent advancements in Computer Vision, particularly in object detection, classification, and image segmentation, have facilitated progress in these areas. However, many existing systems remain inefficient and lack seamless integration, resulting in limited solutions capable of both identifying food items and providing relevant recipe recommendations. Furthermore, modern neural network architectures have yet to be extensively applied to food recognition and recipe recommendation tasks. This study aims to address these limitations by developing a system based on the MobileNetV2 architecture for accurate food item recognition, paired with a recipe recommendation module. The system was trained on a diverse dataset of fruits and vegetables, achieving high classification accuracy (97.2%) and demonstrating robustness under various conditions. Our findings indicate that the modified model, the MobileNetV2 model, can effectively recognize different food items, making it suitable for real-time applications. The significance of this research lies in its potential to improve dietary tracking, offer valuable culinary insights, and serve as a practical tool for both personal and professional use. Ultimately, this work advances food recognition technology, contributing to enhanced health management and fostering culinary creativity. Some potential applications of this work include personalized dietary management, automated meal logging for fitness apps, smart kitchen assistants, restaurant ordering systems, and enhanced food analysis for nutrition tracking. Full article

Background/Objectives: Chronic kidney disease (CKD) requires intensive dietary and lifestyle management, yet patient engagement and access to tailored education remain limited, particularly outside clinical settings. This study describes the development and implementation of NephroGo, and evaluates its usability, user engagement, and perceived acceptability among patients with CKD. Methods: The app was developed based on clinical and dietary guidelines, incorporating personalized nutrient recommendations, dialysis tracking, and educational content. Technically, it features a Django backend, Flutter mobile frontend, and secure cloud-based hosting. User feedback was collected through one-time interviews (n = 10) and a standardized Mobile App Rating Scale (MARS) survey (n = 32). Longitudinal usage data over four years were also analyzed. Results: Initially, NephroGo was downloaded by 204 users, of whom 93.6% were considered active users based on defined behavioral engagement thresholds. Over a four-year period, the app accumulated a total of 1670 downloads. This study focuses on evaluating user engagement, usability, and perceived acceptability of the NephroGo app over a four-year period. Most users were female (52.3%) and aged 30–65. Stage 5 CKD patients and those undergoing peritoneal dialysis (PD) had the highest engagement. The most-used feature was the personalized nutrition calculator, with sodium being the most frequently exceeded nutrient. The average MARS score was 4.09 ± 0.66, with functionality rated highest (4.27 ± 0.74). App ratings were significantly higher among users referred by physicians (p = 0.039). Conclusions: NephroGo offers a scalable digital tool to support dietary management and health monitoring, with potential to complement standard nephrology care in a resource-conscious manner. Full article