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25 pages, 1143 KB  
Perspective
Ironing Out Possible Micronutrient Deficiencies Associated with Incretin Receptor Agonist-Based Therapies: Proposed Practical Strategies to Prevent and Manage Iron Deficiency
by Marco Infante, Camillo Ricordi, Francesca Pacifici, Donatella Pastore, Raffaele Infante, Massimiliano Caprio, Francesca Chiereghin, Alessandro De Stefano, Giulia Frank, Alessio De Rose, Lorenzo Romano, Laura Di Renzo, Valentina Rovella, Antonino De Lorenzo, Giulia Donadel and David Della-Morte
Nutrients 2026, 18(13), 2038; https://doi.org/10.3390/nu18132038 (registering DOI) - 23 Jun 2026
Abstract
Over the last years, incretin receptor agonists—including glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RA) and the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist tirzepatide—have dramatically improved the management of type 2 diabetes, overweight and obesity. However, as the use of incretin receptor agonists [...] Read more.
Over the last years, incretin receptor agonists—including glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RA) and the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist tirzepatide—have dramatically improved the management of type 2 diabetes, overweight and obesity. However, as the use of incretin receptor agonists continues to increase worldwide, micronutrient deficiencies—including iron deficiency—have emerged as newly recognized adverse effects of these drugs. The present article aims to discuss recent preliminary observational evidence on the potential relationship between incretin receptor agonist-based therapies and the development of iron deficiency and iron deficiency anemia (IDA), as well as the potential mechanisms by which incretin receptor agonists may affect iron homeostasis. Potential mechanisms and factors underlying the development of iron deficiency and IDA in patients treated with incretin receptor agonist-based therapies include inadequate dietary iron intake (due to incretin receptor agonist-mediated reduction in food intake and/or gastrointestinal adverse effects of incretin receptor agonists), low dietary variety, monotonous diets, and changes in food preferences, as well as impairment of intestinal iron absorption (due to delayed gastric emptying, reduced small intestinal motility and/or decreased gastric acid secretion caused by incretin receptor agonists). Moreover, vitamin B2 (riboflavin) deficiency and changes in gut microbiota composition are hypothetical mechanisms that may partly explain iron deficiency in patients treated with incretin receptor agonists, although these hypotheses require confirmation through mechanistic studies. Even though iron deficiency and IDA currently appear to be uncommon adverse effects of incretin receptor agonist-based therapies, clinicians should be aware of the possibility of their occurrence to ensure appropriate prevention and management of these nutritional complications. Nevertheless, future prospective studies are certainly needed to better establish the causal relationship between the initiation of incretin receptor agonist-based therapies and the development of iron deficiency/IDA, as well as the exact mechanisms underlying the potential development of these nutritional complications in patients treated with incretin receptor agonists. Meanwhile, the prescription of incretin receptor agonists should not be unjustifiably restricted by the possible and modest risk of iron deficiency and IDA in patients with one or more approved indications for therapeutic use of these agents. Since no established guidelines currently exist for the prevention and management of iron deficiency and IDA in patients treated with incretin receptor agonists, we herein propose practical strategies to address these possible nutritional complications of incretin receptor agonist-based therapies. These proposed strategies should only be regarded as practical clinical approaches deriving from the existing recommendations for the prevention and management of iron deficiency and IDA, although their cost-effectiveness for the prevention and management of incretin receptor agonist-associated iron deficiency/IDA should be appropriately assessed in future clinical trials. Full article
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13 pages, 552 KB  
Article
‘It’s Not About the Food’—Understanding the Lived Experience of Patients Who Developed Hospital-Acquired Malnutrition (HAM) and That of Their Carers
by Michelle Palmer, Angela Vivanti, Breanne Hosking, Fiona Naumann, Sally Courtice, Amanda Henderson, Hazel Harden, Shoni Philpot, Anne Smyth and Lynda Ross
Healthcare 2026, 14(12), 1806; https://doi.org/10.3390/healthcare14121806 (registering DOI) - 22 Jun 2026
Abstract
Background/Objectives: Given the limited evidence internationally, this qualitative study employed discovery interviews to explore the lived experience of patients who developed Hospital-Acquired Malnutrition (HAM) and that of their carers. Methods: Seven (two patients [(n = 1 female] and five carers [n [...] Read more.
Background/Objectives: Given the limited evidence internationally, this qualitative study employed discovery interviews to explore the lived experience of patients who developed Hospital-Acquired Malnutrition (HAM) and that of their carers. Methods: Seven (two patients [(n = 1 female] and five carers [n = 3 female]) completed discovery interviews with an experienced independent interviewer. Carers were either spouses or parents. Responses were thematically analyzed using a constant comparative approach. Results: A key theme was ‘It’s not about the food, it’s the hospital system’ with the needs of the system dominating, including when patients were feeling at their worst. Subthemes were ‘integration of care’ and ‘patient acuity’, including symptoms that impacted food intake. Another theme was ‘Who is looking out for the patient?’, exploring ‘reliance on carer advocacy’, and ‘variation in staff involvement’. One carer said, “… the girl that delivered the meal tray was the only one in our hospital stay who actually said to [the patient], ‘I’m so glad you’re sitting up. I was worried about you because you hadn’t eaten for so long?” A persistent but comparatively less strong theme was ‘When it is about the food’ which explored ‘the quality of the food’ and ‘receiving information on eating and drinking’. Conclusions: The three key themes identified from carers and patients were hospital system impacts, care co-ordination and, less strongly, experiences with food quality and information. The key opportunities to prevent, or better support the nutritional care of patients with, HAM may be through improving systems and care co-ordination. Full article
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18 pages, 392 KB  
Article
Physical Activity During Pregnancy, Dietary Adequacy, and Energy-Dense, Nutrient-Poor Food and Beverage Intake: Associations with Preterm Birth
by Oana Liliana Atomei, Petronela Vicoveanu, Dragos Vicoveanu and Monica Tarcea
Nutrients 2026, 18(12), 2030; https://doi.org/10.3390/nu18122030 (registering DOI) - 22 Jun 2026
Abstract
Background/Objectives: Maternal nutrition and physical activity are modifiable behaviours relevant to pregnancy outcomes, but higher activity may coexist with both favourable and unfavourable dietary patterns. This study examined associations between pregnancy physical activity, individualised fruit–vegetable adequacy, energy-dense, nutrient-poor (EDNP) food and beverage intake, [...] Read more.
Background/Objectives: Maternal nutrition and physical activity are modifiable behaviours relevant to pregnancy outcomes, but higher activity may coexist with both favourable and unfavourable dietary patterns. This study examined associations between pregnancy physical activity, individualised fruit–vegetable adequacy, energy-dense, nutrient-poor (EDNP) food and beverage intake, and preterm birth. Methods: This cross-sectional study included 1048 postpartum women with singleton live births recruited consecutively at a tertiary maternity hospital in Romania. Physical activity during the last three months of pregnancy was assessed using the Pregnancy Physical Activity Questionnaire and categorised into quartiles of total MET-hours/week. Dietary intake was assessed using an adapted food frequency questionnaire. Fruit–vegetable adequacy was evaluated against individualised recommendations, and EDNP intake was summarised using a composite score derived from fast food, sweets, chocolate, and sugar-sweetened beverages. Preterm birth was defined as delivery before 37 completed weeks of gestation. Results: Preterm birth occurred in 118 cases (11.3%). Higher physical activity categories showed greater fruit–vegetable intake and adequacy, but also higher EDNP intake. After adjustment for maternal age, pregestational BMI, parity, education, and income, physical activity category remained associated with all modelled dietary outcomes. Category 4 had higher odds of fruit–vegetable adequacy than category 1 (OR 2.24, 95% CI 1.55–3.24). In diet-informed models, category 3 had the lowest odds of preterm birth (OR 0.38, 95% CI 0.21–0.68). Conclusions: Total physical activity during pregnancy was associated with a complex dietary profile rather than a uniformly favourable lifestyle pattern. The lowest odds of preterm birth were observed in the third activity category, suggesting a non-linear association. Full article
22 pages, 5933 KB  
Article
Dietary Macronutrient Intake and Vascular Health in Patients with Long COVID: The BioICOPER Study
by Nuria Suárez-Moreno, Elena Navarro-Matías, Silvia Arroyo-Romero, Alicia Navarro-Cáceres, Andrea Domínguez-Martín, Cristina Lugones-Sanchez, Susana Gonzalez-Sanchez, Manuel A. Gómez-Marcos, Marta Gómez-Sánchez, Leticia Gómez-Sánchez and BioICOPER Investigators Group
Nutrients 2026, 18(12), 2028; https://doi.org/10.3390/nu18122028 (registering DOI) - 22 Jun 2026
Abstract
Background: Long COVID (LC) has been associated with persistent endothelial dysfunction and vascular impairment. Although nutrition is a key modifiable determinant of cardiovascular health, the relationship between dietary macronutrient intake and vascular alterations in LC remains poorly understood. Objective: To evaluate the association [...] Read more.
Background: Long COVID (LC) has been associated with persistent endothelial dysfunction and vascular impairment. Although nutrition is a key modifiable determinant of cardiovascular health, the relationship between dietary macronutrient intake and vascular alterations in LC remains poorly understood. Objective: To evaluate the association between dietary macronutrient intake and markers of vascular structure, arterial stiffness, and vascular aging in patients with LC, including potential sex differences. Methods: We conducted a cross-sectional study including 304 patients with LC. Dietary intake was assessed using a validated 7-day dietary record (EVIDENT study). Vascular evaluation included carotid intima–media thickness (cIMT), carotid–femoral pulse wave velocity (cfPWV), brachial–ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI), augmentation index adjusted to a heart rate of 75 beats per minute (AIx@75), and vascular aging index (VAI), measured using carotid ultrasound and validated devices (SphygmoCor® and VaSera®). Results: The mean age was 53 ± 12, higher in men (p = 0.001). The study included 207 women (68%) and 97 men (32%). Energy intake and carbohydrate intake in g/day showed a negative association with cfPWV in Model 2 (energy intake: β = −0.06; 95% CI: −0.11 to −0.01; p = 0.02; carbohydrate intake: β = −0.47; 95% CI: −0.87 to −0.07; p = 0.02). The percentage of carbohydrate/total energy intake was positively associated with AIx@75 in Model 2 (β = 0.8; 95% CI 0.12 to 1.49; p = 0.02), and percentage of fat/total energy intake showed a consistent inverse association (β = −0.30; 95% CI: −0.49 to −0.11; p = 0.002). No significant associations were observed for cIMT, baPWV, CAVI or VAI. Conclusions: In patients with LC, total energy intake and absolute carbohydrate intake were negatively associated with cfPWV, whereas the relative contribution of carbohydrates and fats to total energy intake showed divergent associations with AIx@75. These findings suggest that both absolute macronutrient intake and relative macronutrient distribution may be related to central arterial stiffness and wave reflection parameters LC. However, given the cross-sectional design of the study, these results should be interpreted as exploratory and do not allow causal inference. Further longitudinal and interventional studies are needed to confirm these findings and to assess whether nutritional strategies may contribute to modulating vascular risk in this population. Full article
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28 pages, 25169 KB  
Article
Free and Protected Protease in the Diet of Lactating Jersey Cows: Effects on Performance, Milk Quality, Metabolism, Nutrient Digestibility, Microbiota, and Ruminal Environment
by Maksuel Gatto de Vitt, Andrei Lucas Rebelatto Brunetto, Emeline Pizzolatto de Mello, Tainara Letícia dos Santos, Luisa Nora, Beatriz Danieli, Matheus Wroblescki Silva, Sander Souza Farias, Viviane Cargnin de Lima, Bruna Klein, Camila Ten Kathen Jung, Aniela Pinto Kempka, Gilberto Vilmar Kozloski, Roger Wagner, Miklos Maximiliano Bajay and Aleksandro Schafer da Silva
Animals 2026, 16(12), 1926; https://doi.org/10.3390/ani16121926 (registering DOI) - 22 Jun 2026
Abstract
This study evaluated the effects of dietary inclusion of free and protected acid protease on productive performance, milk composition, metabolic profile, nutrient digestibility, and ruminal environment in lactating Jersey cows. Fifteen multiparous cows (67 ± 7.5 days in milk; 27.5 ± 3.5 kg/day) [...] Read more.
This study evaluated the effects of dietary inclusion of free and protected acid protease on productive performance, milk composition, metabolic profile, nutrient digestibility, and ruminal environment in lactating Jersey cows. Fifteen multiparous cows (67 ± 7.5 days in milk; 27.5 ± 3.5 kg/day) were assigned to a 3 × 3 Latin square (5 squares) design with 21-day periods. Treatments consisted of: control (no enzyme), free protease (4.4 g/day), and protected protease (4.4 g/day). The protected form was developed using alginate-based encapsulation to enhance enzyme stability under ruminal conditions. Protease inclusion did not affect dry matter intake, milk yield, or feed efficiency (p > 0.05). However, free protease increased lactation persistency (p = 0.05) and improved fat-corrected and energy-corrected milk yields (p ≤ 0.02), with intermediate responses observed for protected protease. Milk fat and protein contents were higher in enzyme-fed cows (p ≤ 0.05), while other compositional parameters remained unchanged. Apparent crude protein digestibility was greater in cows receiving free protease (p = 0.037), with no effects on dry matter or fiber digestibility. Protease intake increased total volatile fatty acid concentrations and major fermentation products (acetate, propionate, and butyrate; p ≤ 0.01), indicating enhanced ruminal fermentation. Blood metabolites showed increased total protein and globulin levels in cows fed free protease (p ≤ 0.05), suggesting improved protein metabolism. Microbiota analysis revealed no differences in alpha or beta diversity; however, specific microbial taxa and predicted metabolic pathways were modulated by treatments, particularly in post-ruminal compartments. In conclusion, exogenous protease, especially in free form, improved protein utilization and corrected milk production without disrupting microbial stability. These findings highlight the potential of protease as a nutritional strategy to enhance efficiency in dairy systems through targeted modulation of ruminal function and nutrient metabolism. Full article
(This article belongs to the Special Issue Feed Additives in Animal Nutrition: 2nd Edition)
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22 pages, 1567 KB  
Article
Monolaurin in the Diet of Feedlot Finishing Cattle: Effects on Performance, Metabolism, Ruminal Environment, and Meat Fatty Acid Profile
by Julivan Junior Magri, Andrei Lucas Rebelatto Brunetto, Matheus Wroblescki Silva, Thiago Marangoni, Renato Santos de Jesus, Miklos Maximiliano Bajay, Luiz Eduardo Lobo e Silva, Roger Wagner, Gilnei Bruno da Silva, Daiane Manica, Margarete Dulce Bagatini and Aleksandro Schafer da Silva
Fermentation 2026, 12(6), 295; https://doi.org/10.3390/fermentation12060295 (registering DOI) - 21 Jun 2026
Abstract
This study evaluated the effects of monolaurin intake per finishing feedlot cattle on growth performance, metabolic status, ruminal environment, and meat fatty acid profile. Twenty-four castrated Holstein males (379 ± 8.5 kg; 12 months old) were randomly assigned to two treatments: basal diet [...] Read more.
This study evaluated the effects of monolaurin intake per finishing feedlot cattle on growth performance, metabolic status, ruminal environment, and meat fatty acid profile. Twenty-four castrated Holstein males (379 ± 8.5 kg; 12 months old) were randomly assigned to two treatments: basal diet (control) or basal diet with α-monolaurin (treated: 0.762 g/kg dry matter intake; ≈6.63 g/animal/day) for 79 days. Feed intake, body weight, and feed efficiency were recorded, and blood and ruminal samples were collected during the trial. Ruminal fermentation parameters, protozoa counts, hematological and biochemical variables, oxidative status biomarkers, ruminal microbiota composition (16S rRNA sequencing), and Longissimus dorsi fatty acid profile were analyzed. Monolaurin feed did not affect dry matter intake or final body weight, but increased total weight gain, average daily gain, and feed efficiency (p ≤ 0.05), indicating improved nutrient utilization. Hematological and serum biochemical variables were largely unchanged, although total leukocyte counts were lower in treated cattle. Animals receiving monolaurin showed reduced reactive oxygen species and lower superoxide dismutase activity, suggesting improved oxidative balance without changes in lipid peroxidation. During the adaptation phase (day 14), treated cattle exhibited lower acetate, propionate, valerate, and total volatile fatty acid concentrations and higher protozoa counts, but these differences disappeared by day 79, indicating ruminal adaptation. Microbiota diversity was not altered overall, although specific genera differed in relative abundance between treatments. In meat, monolaurin increased lauric, linoleic, and arachidonic acids, reduced palmitic and heptadecanoic acids, decreased total saturated fatty acids, and increased polyunsaturated fatty acids (p ≤ 0.05). Overall, dietary monolaurin improved feed efficiency, modulated oxidative status, induced transient ruminal microbial adjustments, and enhanced the nutritional quality of beef lipids without compromising metabolic health. Full article
(This article belongs to the Section Animal and Feed Fermentation)
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23 pages, 1995 KB  
Article
Preliminary Assessment of Red Beetroot Supplementation and Cultivar Effects in Low-Protein-Fed WKY Rats
by Michał S. Majewski, Anetta Hanć, Magdalena Krajewska-Włodarczyk, Joanna Majkowska-Gadomska and Anna Francke
Nutrients 2026, 18(12), 2016; https://doi.org/10.3390/nu18122016 (registering DOI) - 21 Jun 2026
Abstract
Background/Objectives: Red beetroot (Beta vulgaris L.) is recognized for its antioxidant, anti-inflammatory, and metabolic properties. This study evaluated the effects of two beetroot cultivars (Boldor and Wodan) on blood serum parameters, body composition, and organ weights in male WKY [...] Read more.
Background/Objectives: Red beetroot (Beta vulgaris L.) is recognized for its antioxidant, anti-inflammatory, and metabolic properties. This study evaluated the effects of two beetroot cultivars (Boldor and Wodan) on blood serum parameters, body composition, and organ weights in male WKY rats fed a low-protein diet (LPD, 8.8% protein). Methods: Five-week-old male rats were maintained on an LPD for 8 weeks and subsequently continued on the LPD diet supplemented with 4% dried beetroot for 45 days. The experimental diets included beetroot from the Boldor and Wodan cultivars, either treated or untreated with a plant growth stimulator during cultivation. Results: Foliar application of the selenium-based plant growth stimulator did not significantly increase selenium or other element concentrations in beet roots. Elemental analysis showed higher levels of Fe, Zn, Cu, Cr, Pb, As, Cd, and Sb in the Wodan group, while Boldor increased Cr, Pb, and As; Ni and Se remained unchanged. Beetroot supplementation significantly affected 14 of the 30 measured biochemical parameters, including biomarkers of liver function (ALT, ALP, total bilirubin, albumin, and total protein), renal function (uric acid), pancreatic activity (amylase and lipase), electrolyte balance (sodium, potassium, and chloride), mineral metabolism (calcium), inflammatory status (CRP), and nutritional metabolism (iron). Conversely, no significant effects were observed on lipid profile parameters or biomarkers of cardiac and skeletal muscle injury. Among the beetroot cultivars evaluated, Wodan exerted distinct effects relative to Boldor, resulting in higher circulating total bilirubin and potassium concentrations, alongside reduced uric acid and lipase levels in treated rats. Boldor supplementation significantly increased body weight gain and fat mass, with a trend toward higher lean mass, and increased kidney weight. Wodan did not significantly affect body weight but increased kidney and spleen mass. Feed intake was similar across groups. No changes in cardiovascular function were observed ex vivo. Conclusions: Beetroot supplementation modulated multiple metabolic and physiological biomarkers in rats fed a low-protein diet, with distinct cultivar-specific effects, underscoring the importance of cultivar selection for optimizing functional dietary interventions. Full article
(This article belongs to the Section Phytochemicals and Human Health)
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20 pages, 629 KB  
Article
Psychospiritual Profiles Differentiate Dietary and Lifestyle Behaviors
by Sebastian Binyamin Skalski-Bednarz, Loren L. Toussaint, Magdalena Piegza, Monika Bidzan-Wiącek and Mariola Bidzan
Nutrients 2026, 18(12), 2007; https://doi.org/10.3390/nu18122007 (registering DOI) - 20 Jun 2026
Viewed by 182
Abstract
Background/Objectives: Previous literature has linked nutrition with both psychological distress and well-being. However, less is known about how psychological and spiritual resources cluster within individuals or whether distinct psychospiritual profiles are associated with dietary and lifestyle behaviors. This study examined these associations using [...] Read more.
Background/Objectives: Previous literature has linked nutrition with both psychological distress and well-being. However, less is known about how psychological and spiritual resources cluster within individuals or whether distinct psychospiritual profiles are associated with dietary and lifestyle behaviors. This study examined these associations using a person-centered approach. Methods: A community sample of 522 adults from the United States completed measures of perceived stress, depressive symptoms, coping self-efficacy, gratitude, forgiveness, religiousness/spirituality, daily spiritual experiences, religious/spiritual meaning and beliefs, and dietary and lifestyle behaviors. Latent profile analysis was conducted to identify psychospiritual profiles. Results: Four profiles were identified: Moderate (n = 195), Flourishing (n = 199), Vulnerable (n = 70), and Maladaptive (n = 58). The Flourishing profile demonstrated the most adaptive psychological functioning and was associated with healthier dietary behaviors, including lower breakfast skipping and fast-food consumption, greater whole-grain and vegetable intake, lower salt use, and lower sweets and dessert intake. The Vulnerable profile demonstrated the highest levels of perceived stress and depressive symptoms together with relatively elevated religiousness/spirituality, whereas the Maladaptive profile was characterized by elevated distress and consistently low levels of psychological and spiritual resources. Overall, the Vulnerable and Maladaptive profiles demonstrated less favorable dietary patterns relative to the Flourishing and Moderate profiles. However, the observed effects were generally modest and selective. Conclusions: Dietary and lifestyle behaviors may be associated with broader psychospiritual configurations rather than isolated psychological characteristics alone. The findings additionally highlight the heterogeneous nature of religiousness and spirituality within psychological functioning. Full article
(This article belongs to the Special Issue Nutrition, Stress, and Psychological Well-Being Across the Lifespan)
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18 pages, 274 KB  
Article
Evaluation of Wasted Tofu Meal as an Alternative to Fish Meal in Juvenile Yellowtail, Seriola quinqueradiata
by Amal Biswas, Rino Nakajima, Yuko Fujimoto, Hiroya Sato, Hiroshi Fushimi, Tomoki Honryo and Hideki Tanaka
Fishes 2026, 11(6), 365; https://doi.org/10.3390/fishes11060365 (registering DOI) - 20 Jun 2026
Viewed by 129
Abstract
A six-week feeding experiment was carried out to investigate the suitability of wasted tofu meal (WTM) as a substitute protein source for fish meal (FM) in diets for juvenile yellowtail (Seriola quinqueradiata). A diet containing FM as the principal protein source [...] Read more.
A six-week feeding experiment was carried out to investigate the suitability of wasted tofu meal (WTM) as a substitute protein source for fish meal (FM) in diets for juvenile yellowtail (Seriola quinqueradiata). A diet containing FM as the principal protein source served as the control (C), while WTM was incorporated to replace 20%, 35%, and 50% of the FM protein in the experimental diets, referred to as T20, T35, and T50, respectively. Juvenile fish with an initial average body weight of approximately 30.99 g were randomly distributed into 500-L tanks at a density of 20 fish per tank, with triplicate groups assigned to each dietary treatment. At the end of the feeding trial, fish fed the T20 diet showed no significant differences from the control group in final body weight, specific growth rate, daily feed intake, feed efficiency, or survival. However, fish receiving the T35 and T50 diets exhibited significant reductions in most growth performance indices compared with those fed the control diet. Although nutrient retention efficiency and plasma biochemical indicators associated with fish health were not significantly influenced by dietary treatment, alterations were observed in whole-body lipid composition and fatty acid profiles, including reductions in EPA, DHA, total n-3 fatty acids, and the n-3/n-6 fatty acid ratio with increasing WTM inclusion. Overall, the findings suggest that, under the dietary formulations tested, WTM can replace up to 20% of FM protein in diets for juvenile yellowtail without negatively affecting growth performance or physiological health; however, supplementation with n-3 HUFA-rich lipid sources may be required to maintain optimal whole-body fatty acid composition and product nutritional quality. Full article
32 pages, 969 KB  
Review
Stevia Rebaudiosides Usage as a Sugar Reduction Tool: A Narrative Review of Their Metabolic, Gut Microbiome and Weight Management Effects in Human Clinical Studies
by Corey Scott, Nikoleta Stamataki and John McLaughlin
Nutrients 2026, 18(12), 2002; https://doi.org/10.3390/nu18122002 (registering DOI) - 20 Jun 2026
Viewed by 86
Abstract
Background/Objectives: Stevia rebaudiosides represent a class of compounds extracted from the Stevia rebaudiana Bertoni plant or produced via yeast fermentation, which provide a sweet taste with little to no calories. These compounds are commercially referred to as stevia and are used in the [...] Read more.
Background/Objectives: Stevia rebaudiosides represent a class of compounds extracted from the Stevia rebaudiana Bertoni plant or produced via yeast fermentation, which provide a sweet taste with little to no calories. These compounds are commercially referred to as stevia and are used in the food industry to reduce sugar in foods and beverages. Stevia is a non-nutritive sweetener (NNS), which is a class of ingredients which represent both artificial and plant-based sweeteners. NNSs are widely used and have been well studied. However, their effects on efficacy for weight management as a sugar reduction tool and overall metabolic effects are inconsistent. Of the approved NNSs for use, stevia is relatively new and one of the least studied. However, recent human clinical research has provided insights into stevia’s metabolic effects, effects on the gut microbiome and effects on weight management when used to replace sugar. The objective of this narrative review of human clinical studies is to provide an overview of the effects of stevia rebaudiosides (largely rebaudioside A) on glucoregulatory and cardiometabolic functions, as well as their effects on gut microbiome and weight management. These studies were typically short term (acute to three months) and heterogeneous by design, and they contained stevia rebaudiosides as lone sweeteners and as part of a binary blend with other NNSs. The majority of metabolic studies on stevia rebaudiosides have evaluated the effects on glucose homeostasis and, to a lesser extent, the effects on cardiometabolic function, the gut microbiome, and weight management. These studies suggest that stevia rebaudiosides have no statistically significant effects on glycemia, insulinemia, blood lipids, appetite hormones, or the gut microbiome. Limited studies suggest that, particularly when compared to sucrose, stevia produces very modest body weight and BMI changes, while studies on subjective appetite and food intake have had inconsistent results. Conclusions: longer-term studies are needed, with more consistent and rigorous design protocols across various populations. However, current human clinical studies suggest that stevia rebaudiosides have a limited impact on metabolic functions, and the observed effects on gut microbiome and changes in body weight, particularly when used to replace sugar, warrant further study. Full article
39 pages, 844 KB  
Review
Sarcopenia and Frailty in COPD: Mechanisms, Relationship with Malnutrition and Potential Therapeutic Interventions
by Saoussen Naas, Mónika Fekete, Riad Bejta, Regina Bakos, Borbála Szalai and János Tamás Varga
Nutrients 2026, 18(12), 2003; https://doi.org/10.3390/nu18122003 (registering DOI) - 20 Jun 2026
Viewed by 75
Abstract
Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable [...] Read more.
Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable driver of muscle deterioration in COPD. Nutritional deficits impair anabolic signaling, exacerbate proteolysis, worsen mitochondrial dysfunction, and contribute to frailty progression. Methods: This narrative review synthesizes evidence from PubMed, Embase, Scopus, and Web of Science up to 2025, integrating mechanistic, metabolic, nutritional, and biomarker-related pathways underlying muscle dysfunction in COPD. Studies examining inflammation, hypoxemia, oxidative stress, hormonal imbalance, nutrition, and emerging biomarkers were included. Results: COPD-related sarcopenia results from converging inflammatory (TNF-α, IL-6), catabolic (FOXO, UPS), metabolic, and vascular mechanisms, compounded by energy deficiency, protein insufficiency, and micronutrient deficits. Inadequate intake of protein, vitamin D, antioxidants, and omega-3 fatty acids increase anabolic resistance, enhance muscle catabolism, and worsen frailty. Nutritional interventions, particularly high-protein supplementation, leucine-enriched formulas, vitamin D repletion, omega-3 fatty acids, and multimodal nutrition–exercise programs, demonstrate benefits in muscle mass, strength, and physical performance. Biomarkers such as GDF-15, CAF22, and specific microRNAs reflect nutritional status and correlate with muscle health in COPD. Conclusions: Sarcopenia and frailty in COPD arise from a complex interplay of inflammatory, metabolic, nutritional, and lifestyle-related factors. Integrating nutritional assessment and targeted dietary interventions with exercise and pulmonary rehabilitation is essential to counteract anabolic resistance and improve functional outcomes. Advances in biomarker research may support earlier diagnosis and personalized nutrition-based therapeutic strategies. Full article
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17 pages, 890 KB  
Article
Evaluating Carotenoids Intake of Pregnant Women: A FFQ-Based Approach to Dietary Patterns
by Andreea-Maria Mitran, Alina-Delia Popa, Catalin-Mihail Chiru, Cornelia Mircea, Ionut Iulian Lungu, Ioana-Cezara Caba, Andreea Lungu, Cristina Arsene, Dumitru Gafitanu, Florina Crivoi, Monica Hancianu, Cristina Elena Dobre and Oana Cioanca
Nutrients 2026, 18(12), 1999; https://doi.org/10.3390/nu18121999 (registering DOI) - 19 Jun 2026
Viewed by 162
Abstract
Background: Pregnancy is a vital period during which maternal nutrition profoundly influences both maternal health and fetal development. Carotenoids, predominantly found in fruits and vegetables, are bioactive compounds that enhance antioxidant defenses and facilitate vitamin A metabolism throughout pregnancy. However, assessing carotenoids intake [...] Read more.
Background: Pregnancy is a vital period during which maternal nutrition profoundly influences both maternal health and fetal development. Carotenoids, predominantly found in fruits and vegetables, are bioactive compounds that enhance antioxidant defenses and facilitate vitamin A metabolism throughout pregnancy. However, assessing carotenoids intake presents challenges due to the lack of dietary assessment tools capable of quantifying individual carotenoids, coupled with limited data from populations in Eastern Europe. Methods: A cross-sectional study involving 621 pregnant women in Romania was conducted to estimate dietary carotenoids intake and investigate associations with dietary patterns and overall diet quality. Dietary data were obtained using the EPIC Food Frequency Questionnaire (EPIC-FFQ), adapted for Romanian populations. A dedicated carotenoid estimation model was developed utilizing the USDA Carotenoid Database. Principal component analysis (PCA) was employed to identify dietary patterns, and diet quality was evaluated using the Diet Quality Index during Pregnancy (DQI-P). Results: The findings revealed significant individual variability. The median intake was highest for β-carotene (2464 μg), and lycopene (1664 μg), followed by lutein and zeaxanthin (908 μg), α-carotene (615 μg), and β-cryptoxanthin (121 μg). The Vegetable-meal pattern exhibited the strongest positive correlation with carotenoids intake, whereas the Energy-dense pattern was primarily associated with vitamin E and tocopherols/tocotrienols, and the Mixed pattern with vitamins A and D. Higher DQI-P scores were consistently correlated with increased carotenoids consumption. Conclusions: Overall, maternal carotenoids intake during pregnancy was frequently insufficient and showed considerable variation among women. A diet rich in vegetables and higher overall diet quality were associated with elevated carotenoids intake levels. These findings enhance the understanding of dietary carotenoids intake among pregnant women in Eastern Europe. Full article
(This article belongs to the Special Issue Women’s Special Issue Series: Nutrients)
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16 pages, 2129 KB  
Article
Impact of Mid-to-Late Gestational Overfeeding on Maternal Performance and Calf Outcomes in Hanwoo Cattle: A Machine Learning Approach
by Myungsun Park, Borhan Shokrollahi, Gi Suk Jang, Shil Jin, Sung Jin Moon, Kyung Hwan Um, Sun Sik Jang and Youl Chang Baek
Animals 2026, 16(12), 1902; https://doi.org/10.3390/ani16121902 (registering DOI) - 19 Jun 2026
Viewed by 145
Abstract
This study evaluated the effects of maternal overfeeding during mid-to-late gestation on maternal productivity, metabolic status, reproductive recovery, and calf performance in Hanwoo cattle using conventional statistics and machine learning (ML) approaches. A total of 243 pregnant cows were assigned to either a [...] Read more.
This study evaluated the effects of maternal overfeeding during mid-to-late gestation on maternal productivity, metabolic status, reproductive recovery, and calf performance in Hanwoo cattle using conventional statistics and machine learning (ML) approaches. A total of 243 pregnant cows were assigned to either a control group or an overfeeding group from gestation day 90 to parturition. The overfeeding treatment increased nutrient supply to approximately 140–145% of the control level. Maternal body weight (BW), body condition score (BCS), serum metabolites, and reproductive traits were evaluated throughout gestation and postpartum, while calf growth, morphometrics, and metabolic traits were assessed at birth and weaning. Calves were further classified into growth- or meat-quality-oriented genotypes using SNP-based profiling. Overfeeding increased maternal BW gain and BCS during gestation and reduced circulating non-esterified fatty acid concentrations, indicating improved maternal energy status. However, overfed cows showed a longer interval to postpartum estrus return. Calf birth weight was not significantly affected by maternal overfeeding, whereas calf growth and morphometric traits at weaning were more strongly influenced by parity, sex, and genotype. Machine learning models identified gestational BW, metabolic indicators, calf feed intake, and genotype as major predictors of maternal and calf outcomes, with random forest and XGBoost showing superior predictive performance compared with linear models. These findings suggest that parity- and genotype-informed nutritional management combined with ML-based prediction may support precision feeding strategies in beef cattle production systems. Full article
(This article belongs to the Section Cattle)
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20 pages, 2759 KB  
Article
Sulfur Supply Modulates Selenium Biofortification, Yield, and Nutritional Quality in Leafy Greens Grown in an Indoor Vertical Farm
by Aysenur Bayrak and Umit Baris Kutman
Agronomy 2026, 16(12), 1193; https://doi.org/10.3390/agronomy16121193 - 18 Jun 2026
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Abstract
Selenium (Se) is essential for human health, but its dietary intake remains insufficient in many regions, increasing interest in biofortification strategies. Indoor hydroponic systems offer a controlled and resource-efficient approach for producing Se-enriched leafy greens. Sulfur (S), an essential macronutrient for plants, affects [...] Read more.
Selenium (Se) is essential for human health, but its dietary intake remains insufficient in many regions, increasing interest in biofortification strategies. Indoor hydroponic systems offer a controlled and resource-efficient approach for producing Se-enriched leafy greens. Sulfur (S), an essential macronutrient for plants, affects Se uptake and metabolism due to their chemical similarity. In this study, we investigated the effects of Se supplementation (2 µM Na2SeO4) under two S levels (0.65 and 1.3 mM, supplied as MgSO4) on Se accumulation, yield, and nutritional quality in lettuce, rocket, and basil grown in an indoor nutrient film technique (NFT) system. High S supply increased biomass in lettuce and basil by 16% and 25%, respectively, while rocket remained unaffected. The effect of Se on biomass depended on S status and species. Under low S conditions, Se increased lettuce biomass but reduced basil biomass, whereas no significant effects were observed under high S. Sulfur strongly reduced Se accumulation in all species, leading to lower contributions to the recommended daily allowance (RDA). Under low S conditions, Se-biofortified lettuce, rocket, and basil provided 111%, 179%, and 37% of the RDA per serving, respectively, whereas these values decreased to 56%, 64%, and 20% under high S. Sulfur and Se treatments also influenced macro- and micro-nutrient composition in a species-dependent manner. Se supplementation consistently reduced total phenolic content and antioxidant capacity (DPPH and FRAP) across all species. Total ascorbic acid was affected only in rocket, with the highest levels observed under high S without Se. These findings highlight a clear antagonistic interaction between S and Se in hydroponic systems and demonstrate the need to optimize S supply to balance yield and Se biofortification without compromising nutritional quality in leafy greens grown in indoor systems. Full article
(This article belongs to the Section Horticultural and Floricultural Crops)
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14 pages, 600 KB  
Article
Changes in Bone Parameters and Serum Zinc Levels Following Oral Zinc Supplementation in Duchenne Muscular Dystrophy: A Quasi-Experimental Study
by Thaís Borges, Evellyn Grilo, Thais Alves Cunha, Luana Lima, Karina Vermeulen-Serpa, Mário Dourado-Júnior, Marília Lopes, Núbia Torres, Breno Bezerra, José Brandão-Neto and Sancha Vale
Int. J. Environ. Res. Public Health 2026, 23(6), 812; https://doi.org/10.3390/ijerph23060812 - 18 Jun 2026
Viewed by 147
Abstract
Individuals with Duchenne muscular dystrophy (DMD) are prone to nutritional imbalances, and zinc deficiency may contribute to impaired bone health. This study evaluated serum zinc status and the effects of oral supplementation on bone parameters in DMD. In this quasi-experimental before-and-after study, 34 [...] Read more.
Individuals with Duchenne muscular dystrophy (DMD) are prone to nutritional imbalances, and zinc deficiency may contribute to impaired bone health. This study evaluated serum zinc status and the effects of oral supplementation on bone parameters in DMD. In this quasi-experimental before-and-after study, 34 patients were assessed at three time points over eight months. Eligible participants who met the inclusion criteria and agreed to participate received the proposed interventions during routine follow-up at the Neurology outpatient clinic. Anthropometry, dietary intake, bone mineral density (BMD), bone mineral content (BMC), and serum zinc were measured; supplementation (5–15 mg/day) was provided for four months. Baseline zinc deficiency was observed in 36.7% of participants. No significant overall changes were detected. Stratified analyses revealed a modest increase in total body BMD among individuals with adequate baseline BMD (p = 0.02). As this finding emerged from a subgroup analysis, it should be interpreted cautiously, and the potential contribution of physiological growth to the observed change cannot be excluded. In addition, zinc-deficient participants showed a significant rise in serum zinc levels (p = 0.008). These findings suggest that the response to zinc supplementation may vary according to baseline nutritional and skeletal status and underscore the relevance of micronutrient monitoring in individuals with DMD. Trial registration: The trial was also registered in the Brazilian Registry of Clinical Trials under the code RBR-7cfdxm, approved on 14 June 2018. Full article
(This article belongs to the Special Issue Healthcare Delivery and Nutritional Support in Rare Diseases)
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