Search Results (3,047)

Background/Objectives: Dietary patterns have changed over time, characterising a process of nutritional transition that reflects socioeconomic and demographic inequalities among different populations. This study assessed changes in dietary consumption patterns and the associated social determinants, comparing two time periods in a sample of individuals from a state in the Northeast Region of Brazil. Methods: Data from the 2008–2009 and 2017–2018 Household Budget Survey for the state of Paraíba were analysed, totalling 951 and 1456 individuals, respectively. Foods were categorised according to the NOVA classification and compared based on sociodemographic and economic variables. To determine the factors that most strongly explain the contribution of each NOVA food group to the diet, beta regression analysis was conducted. Results: Differences were observed between the two periods regarding the dietary contribution of the NOVA food groups, with a decrease in consumption of unprocessed foods and an increase in ultra-processed foods. Living in urban areas, being an adolescent, and having an income above the minimum wage were associated with reduced intake of unprocessed foods in both periods. Additionally, being an adolescent and having more than eight years of schooling were associated with higher consumption of ultra-processed foods. Conclusions: The population under study showed changes in food consumption, reflecting a transition process that is occurring unevenly across socioeconomic and demographic groups, thereby reinforcing social inequalities. These findings can guide priorities in food and nutrition policies, highlighting the need for intervention studies to evaluate the effectiveness of such actions. Full article

Macroalgae (seaweeds) produce unique bioactive metabolites that have enabled their survival for millions of years, offering significant potential for human benefits. In the Israeli Mediterranean Sea, no comprehensive systematic surveys of seaweeds have been published since the 1990s, and their chemical composition remains largely unexplored. This study presents an extensive survey of intertidal seaweed communities along the shallow Israeli coastline, documenting their spatial, temporal, and biochemical diversity. Of the 320 specimens collected, 55 seaweed species were identified: 29 red (Rhodophyta), 14 brown (Phaeophyceae), and 12 green (Chlorophyta). A significant shift in species abundance was documented, with a single dominant annual bloom occurring during spring, unlike previously reported biannual blooms. Chemical analysis of the dominant species revealed significant seasonal variations in compound levels, with higher protein content in winter and increased antioxidant capacity during spring. Phenolic and natural sunscreen compounds (mycosporine-like amino acids, MAAs) showed no general seasonal trend. These findings highlight the optimal environmental conditions for seaweed growth and underscore their potential for aquaculture and biotechnology. We hypothesize that the ecologically unique conditions of the Israeli Mediterranean Sea may foster resilient seaweed species enriched with distinctive chemical properties, suitable for nutritional, health, pharmaceutical, and nutraceutical applications, particularly as climate-adaptive bioresources. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease. It has known multifactorial pathophysiology, but the impact of social determinants of health (SDOH) on the rising prevalence of MASLD is poorly understood. We conducted a retrospective cross-sectional study to examine the influence of SDOH on MASLD using nationwide data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES) study. Methods: We identified participants with MASLD based on liver ultrasound-based controlled attenuation parameter measurements consistent with diagnostic guidelines. We then used logistic regression models to examine associations between SDOH variables and MASLD, with a pre-specified focus on education and income, sequentially adjusting for sociodemographic factors, medical comorbidities, and other SDOH. Results: Our study found that higher education (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.62–0.97, p = 0.024) but not higher income (OR 1.12, 95% CI 0.91–1.37, p = 0.3) was associated with lower odds of MASLD in multivariable adjusted models. We also identified a significant interaction between education level and food security, as well as interactions between food security and other significant SDOH. In the stratified analyses, higher education was significantly associated with lower odds of MASLD among participants with food security (OR 0.71, 95% CI 0.55–0.91, p = 0.007) but not among those with food insecurity (OR 1.26, 95% CI 0.76–2.11, p = 0.4). Conclusions: Our findings identify the potential impact of SDOH on odds of MASLD and suggest increased importance of food security relative to other SDOH. Full article

Background/Objectives: The association between chronic kidney disease (CKD) and body size phenotypes in metabolically diverse but apparently healthy adult populations remains inadequately understood. This study investigated the association between CKD and body size phenotypes in a nationally representative sample of healthy Korean adults. Methods: Data from 8227 participants in the 2019–2021 Korean National Health and Nutrition Examination Survey were analyzed. Participants were categorized into four body size phenotypes by combining BMI status (normal weight or obese) with metabolic health status (healthy or abnormal)—MHNW (Metabolically Healthy Normal Weight), MANW (Metabolically Abnormal Normal Weight), MHO (Metabolically Healthy Obese), or MAO (Metabolically Abnormal Obese). CKD was defined based on the urine albumin-to-creatinine ratio and estimated glomerular filtration rate (eGFR). To assess the association between CKD and body size phenotypes, multivariable logistic regression analyses were performed. Results: CKD prevalence was 4.4%. MANW and MAO made up 12.6% and 26.4% of the CKD group, compared to 5.0% and 13.2% of the non-CKD group. CKD prevalence by phenotype was observed as follows: MHNW, 3.2%; MANW, 10.5%; MHO, 4.0%; and MAO, 8.5%. CKD odds were highest in the MAO group (OR: 3.770, 95% CI: 2.648–5.367), followed by the MANW (OR: 2.492, 95% CI: 1.547–4.016) and MHO (OR: 1.974, 95% CI: 1.358–2.870) groups. MAO individuals carried a higher CKD risk than MHO individuals (OR: 1.897, 95% CI: 1.221–2.945). Conclusions: Among apparently healthy adults, body size phenotypes—particularly those with metabolic abnormalities—were significantly associated with the presence of CKD. These findings highlight the need to assess both metabolic health and body composition for effective CKD prevention and management. Full article

As veganism becomes more popular, the number of vegan pregnant women and children is steadily increasing. During vegan pregnancy and early childhood, there is a high risk for nutrient deficiencies that may impair child development. External factors, such as healthcare advice, social networks, and social environments, that affect the diet of vegan pregnant women, parents, and their children, as well as their approach towards dietary supplementation, have not yet been investigated. Various sources of information, combined with a lack of expertise, sparse food and nutritional health literacy, and qualitatively heterogeneous information provision by medical experts, unsettle vegan pregnant women and parents and affect their dietary choices and potentially the health of their children. The VedieS study aims to investigate potential connections between external influences and associated impacts on a vegan diet and the intake of dietary supplements (DS) of pregnant women and children. Two surveys are being conducted within the study: one targeting 1000 vegan pregnant women and parents, and another targeting 60 experts in each of five healthcare groups: gynecologists, pediatricians, general practitioners, pharmacists, and dietitians. This study is the first to examine how socio-economic, social, and further informational factors influence dietary practices during vegan pregnancy and childhood. It highlights the need for reliable, expert-led guidance, as current information sources are often inconsistent and may put these vulnerable groups at risk. Full article

Background/Objective: Food insecurity refers to social or economic challenges that limit or create uncertainty around access to enough food. Among college students, food security status is usually determined with the USDA 10-item Food Security Survey Module, which has not been validated for this population. Nutrition security refers to consistent access to food and beverages that promote well-being, prevent disease, and emphasize equitable access to healthy, safe, and affordable foods. Currently, there is no standardized measure that assesses food and nutrition security tailored to the unique experiences of college students. This study aims to evaluate the validity and reliability of a newly developed College Student Food and Nutrition Security Survey Module (CS-FNSSM). Methods: A mixed-methods approach that combined an online survey with semi-structured cognitive interviews. Participants were students aged 18 and older from U.S. public universities. Quantitative data were analyzed using RStudio (version 4.4.1), and interview transcripts were thematically analyzed. Results: Survey responses were collected from 953 participants, including a subset of 69 participants for reliability testing and 30 participants for cognitive interviews. Rasch analysis showed good item performance and structural validity. The CS-FNSSM demonstrated strong sensitivity (89.09%), specificity (76.2%), moderate test–retest reliability (0.59), and good internal consistency (Cronbach’s alpha = 0.79). Qualitative findings confirmed participant understanding of the items. Conclusions: The CS-FNSSM effectively identifies food and nutrition insecurity, with nutrition security emerging as a key issue. Addressing both is crucial for promoting the overall health and well-being of college students. Full article

Seafood processing byproducts (SB) such as bones and skin can be safely used as food ingredients to increase profitability for the seafood sector and provide nutritional value. An online survey of 716 US adult seafood consumers was conducted to explore SB trial intent, responsiveness to health and safety information, and associated elicited emotions (nine-point Likert scale). Consumers’ SB-elicited emotions were defined as those changing in reported intensity (from a baseline condition) after the delivery of SB-related information (dependent t-tests). As criteria for practical significance, a raw mean difference of >0.2 units was used, and Cohen’s d values were used to classify effect sizes as small, medium, or large. Differences in willingness-to-try, responsiveness to safety and health information, and SB-elicited emotions were found based on self-reported gender and race, with males and Hispanics expressing more openness to SB consumption. SB-elicited emotions were then used to model consumers’ willingness-to-try foods containing SB via logistic regression modeling. Traditional stepwise variable selection was compared to variable selection using raw mean difference > 0.2 units and Cohen’s d > 0.50 constraints for SB-elicited emotions. Resulting models indicated that extrinsic information considered at the point of decision-making determined which emotions were relevant to the response. These new approaches yielded models with increased Akaike Information Criterion (AIC) values (lower values indicate better model fit) but could provide simpler and more practically meaningful models for understanding which emotions drive consumption decisions. Full article

Introduction: The sodium-to-potassium (Na:K) ratio in the diet is a critical biomarker for cardiovascular and metabolic health, yet global adherence to recommended levels remains poor. Objectives: The objective of this study was to identify dietary determinants of the dietary Na:K ratio and its associations with micronutrient intake and diet quality. Methods: An observational cross-sectional survey was conducted in a representative sample of manufacturing workers through a combined stratified proportional and two-stage probability sampling plan, with strata defined by company size and industrial sector from the state of Rio Grande do Norte, Brazil. Dietary intake was assessed using 24 h recalls via the Multiple Pass Method, with Na:K ratios calculated from quantified food composition data. Diet quality was assessed with the Diet Quality Index-International (DQI-I). Multiple linear regression was used to analyze associations of Na:K ratio with the study variables. Results: The survey was conducted in the state of Rio Grande do Norte, Brazil, in 921 randomly selected manufacturing workers. The sample mean age was 38.2 ± 10.7 years, 55.9% males, mean BMI 27.2 ± 4.80 kg/m². The mean Na:K ratio was 1.97 ± 0.86, with only 0.54% of participants meeting the WHO recommended target (<0.57). Fast food (+3.29 mg/mg per serving, p < 0.001), rice, bread, and red meat significantly increased the ratio, while fruits (−0.16 mg/mg), dairy, white meat, and coffee were protective. Higher Na:K ratios were associated with lower intake of calcium, magnesium, phosphorus, and vitamins C, D, and E, as well as poorer diet quality (DQI-I score: −0.026 per 1 mg/mg increase, p < 0.001). Conclusions: These findings highlight the critical role of processed foods in elevating Na:K ratios and the potential for dietary modifications to improve both electrolyte balance and micronutrient adequacy in industrial workers. The study underscores the need for workplace interventions that simultaneously address sodium reduction, potassium enhancement, and overall diet quality improvement tailored to socioeconomic and cultural contexts, a triple approach not previously tested in intervention studies. Future studies should further investigate nutritional consequences of imbalanced Na:K intake. Full article

Antimicrobial Resistance (AMR), i.e., the evolution of microbes to become resistant to chemicals used to control them, is a global public health concern that can make bacterial diseases untreatable. Inputs including antibiotics, metals, and biocides can create an environment in the agrifood chain that selects for AMR. Consumption of food represents a potential exposure route to AMR microbes and AMR genes (ARGs), which may be present in viable bacteria or on free DNA. Ready-to-eat (RTE) foods are of particular interest because they are eaten without further cooking, so AMR bacteria or ARGs that are present may be consumed intact. They also represent varied production systems (fresh produce, cooked meat, dairy, etc.). An evidence gap exists regarding the diversity and consumption of ARGs in RTE food, which this study begins to address. We sampled 1001 RTE products at retail sale in the UK, in proportion to their consumption by the UK population, using National Diet and Nutrition Survey data. Bacterial DNA content of sample extracts was assessed by 16S metabarcoding, and 256 samples were selected for metagenomic sequencing for identification of ARGs based on consumption and likely bacterial DNA content. A total of 477 unique ARGs were identified in the samples, including ARGs that may be involved in resistance to important antibiotics, such as colistin, fluoroquinolones, and carbapenems, although phenotypic AMR was not measured. Based on the incidence of ARGs in food types, ARGs are estimated to be present in a high proportion of average diets. ARGs were detected on almost all RTE food types tested (48 of 52), and some efflux pump genes are consumed in 97% of UK diets. Full article

Background: Environmental exposures, such as per- and polyfluoroalkyl substances (PFAS), in conjunction with social and behavioral factors, can significantly impact liver health. This research investigates the combined effects of PFAS (perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), alcohol consumption, smoking, income, and education on liver function among the U.S. population, utilizing data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). Methods: PFAS concentrations in blood samples were analyzed using online solid-phase extraction combined with liquid chromatography–tandem mass spectrometry (LC-MS/MS), a highly sensitive and specific method for detecting levels of PFAS. Liver function was evaluated using biomarkers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), total bilirubin, and the fatty liver index (FLI). Descriptive statistics and multivariable linear regression analyses were employed to assess the associations between exposures and liver outcomes. Bayesian Kernel Machine Regression (BKMR) was utilized to explore the nonlinear and interactive effects of these exposures. To determine the relative influence of each factor on liver health, Posterior Inclusion Probabilities (PIPs) were calculated. Results: Linear regression analyses indicated that income and education were inversely associated with several liver injury biomarkers, while alcohol use and smoking demonstrated stronger and more consistent associations. Bayesian Kernel Machine Regression (BKMR) further highlighted alcohol and smoking as the most influential predictors, particularly for GGT and total bilirubin, with posterior inclusion probabilities (PIPs) close to 1.0. In contrast, PFAS showed weaker associations. Regression coefficients were small and largely non-significant, and PIPs were comparatively lower across most liver outcomes. Notably, education had a higher PIP for ALT and GGT than PFAS, suggesting a more protective role in liver health. People with higher education levels tend to live healthier lifestyles, have better access to healthcare, and are generally more aware of health risks. These factors can all help reduce the risk of liver problems. Overall mixture effects demonstrated nonlinear trends, including U-shaped relationships for ALT and GGT, and inverse associations for AST, FLI, and ALP. Conclusion: These findings underscore the importance of considering both environmental and social–behavioral determinants in liver health. While PFAS exposures remain a long-term concern, modifiable lifestyle and structural factors, particularly alcohol, smoking, income, and education, exert more immediate and pronounced effects on hepatic biomarkers in the general population. Full article

Food safety concerns related to pesticide residues in fruits and vegetables have increased globally, particularly in regions where monitoring programs are scarce or inconsistent. This study provides the first multi-year evaluation of pesticide contamination and associated dietary risks in Cape Verde, an African island nation increasingly reliant on imported produce. A total of 570 samples of fruits and vegetables—both locally produced and imported—were collected from major markets across the country between 2017 and 2020 and analyzed using validated multiresidue methods based on gas chromatography coupled to Ion Trap mass spectrometry (GC-IT-MS/MS), and both gas and liquid chromatography coupled to triple quadrupole tandem mass spectrometry (GC-QqQ-MS/MS and LC-QqQ-MS/MS). Residues were detected in 63.9% of fruits and 13.2% of vegetables, with imported fruits showing the highest contamination levels and diversity of compounds. Although only one sample exceeded the maximum residue limits (MRLs) set by the European Union, 80 different active substances were quantified—many of them not authorized under the current EU pesticide residue legislation. Dietary exposure was estimated using median residue levels and real consumption data from the national nutrition survey (ENCAVE 2019), enabling a refined risk assessment based on actual consumption patterns. The cumulative hazard index for the adult population was 0.416, below the toxicological threshold of concern. However, when adjusted for children aged 6–11 years—taking into account body weight and relative consumption—the cumulative index approached 1.0, suggesting a potential health risk for this vulnerable group. A limited number of compounds, including omethoate, oxamyl, imazalil, and dithiocarbamates, accounted for most of the risk. Many are banned or heavily restricted in the EU, highlighting regulatory asymmetries in global food trade. These findings underscore the urgent need for strengthened residue monitoring in Cape Verde, particularly for imported products, and support the adoption of risk-based food safety policies that consider population-specific vulnerabilities and mixture effects. The methodological framework used here can serve as a model for other low-resource countries seeking to integrate analytical data with dietary exposure in a One Health context. Full article

Background: Metabolic syndrome (MetS) is a multifactorial condition involving central obesity, dyslipidemia, hypertension, and impaired glucose metabolism, significantly increasing the risk of type 2 diabetes and cardiovascular disease. Objectives: Given the clinical heterogeneity of MetS, this study aimed to identify distinct metabolic phenotypes, referred to as metabotypes, using validated biomarkers and to examine their association with MetS. Materials and Methods: A total of 1245 Korean adults aged 19–79 years were selected from the 2016–2023 Korea National Health and Nutrition Examination Survey. Metabotype risk clusters were derived using k-means clustering based on five biomarkers: body mass index (BMI), uric acid, fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDLc), and non-HDL cholesterol (non-HDLc). Multivariable logistic regression was used to assess associations with MetS. Results: Three distinct metabotype risk clusters (low, intermediate, and high risk) were identified. The high-risk cluster exhibited significantly worse metabolic profiles, including elevated BMI, FBG, HbA1c, triglyceride, and reduced HDLc. The prevalence of MetS increased progressively across metabotype risk clusters (OR: 5.46, 95% CI: 2.89–10.30, p < 0.001). In sex-stratified analyses, the high-risk cluster was strongly associated with MetS in both men (OR: 9.22, 95% CI: 3.49–24.36, p < 0.001) and women (OR: 3.70, 95% CI: 1.56–8.75, p = 0.003), with notable sex-specific differences in lipid profiles, particularly in HDLc. Conclusion: These findings support the utility of metabotyping using routine biomarkers as a tool for early identification of high-risk individuals and the development of personalized prevention strategies in clinical and public health settings. Full article

Root caries is a form of decay affecting root surfaces of teeth, often exacerbated by periodontal disease, reduced salivary flow, and compromised mucosal health, all factors strongly influenced by nutrition. Despite this connection, few studies have addressed the role of vitamins in oral health. This study examines the association between serum levels of alpha-carotene (α-carotene), a potent antioxidant and proxy for vitamin A, and the experience of root caries. Using data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES), we conducted a cross-sectional analysis and applied a weighted multiple logistic regression model, adjusting for potential confounders including age, sex, education level, race, income-to-poverty ratio, and presence of gum disease. Higher serum α-carotene levels were inversely associated with root caries. Each unit increase in serum α-carotene was associated with a 9% decrease in the odds of having root caries (OR = 0.91; 95% CI: 0.86–0.97; p = 0.004). In this nationally representative sample of U.S. adults, lower serum α-carotene levels were associated with a higher prevalence of root caries. These findings highlight the potential role of nutritional assessment and integration in oral health. Longitudinal and mechanistic studies are needed to confirm and further explore α-carotene’s effects on oral health. Full article

Background/Objective(s): Post-discharge clinical needs of extremely preterm (EP) infants are not well defined. The aim of this study is to evaluate healthcare utilization after discharge in infants born EP and compare it to the general pediatric population. Methods: This study involved a post hoc analysis of infants born 24-0/7 to 27-6/7 weeks’ gestation enrolled in the Preterm Erythropoietin Neuroprotection (PENUT) Trial who had at least one follow-up survey representing their course between 24 and 60 months of age. The results were compared to the general population data from the Kids’ Inpatient Database, Nationwide Emergency Department Sample, and National Health and Nutrition Examination Survey. Results: Maternal, infant, and hospitalization characteristics for PENUT infants who survived to discharge (n = 828) compared to those with follow-up (n = 569) were similar except for race and maternal age. Overall, EP infants had an overall lower rate of ED visits (31% vs. 68%) but a higher rate of hospitalizations (11% vs. 3%). EP infants were less likely to go to the ED for gastrointestinal (5% vs. 12%) and dermatologic (1% vs. 6%) concerns but more likely to go to the ED for procedures (7% vs. <1%). EP infants had a higher rate of medication use (56% vs. 14%) in all categories except psychiatric medications. Conclusions: While EP infants had higher rates of specialty healthcare utilization relative to the general pediatric population, they were less likely to visit the ED overall, particularly for common concerns in this age range. This may reflect improved access and navigation of the healthcare system by EP caregivers. Full article

Background/Objectives: Recent Japanese guidelines recommend using the average sodium-to-potassium (Na/K) ratio from casual urine samples to assess hypertension and cardiovascular risk, suggesting cutoffs of 2 (optimal) and 4 (feasible). We aimed to evaluate the proportion of Korean individuals who would be classified as having elevated Na/K ratios using these cutoffs, based on random urine Na/K measurements obtained from the nationally representative Korea National Health and Nutrition Examination Survey (KNHANES) dataset. Methods: We analyzed 50,440 participants from the KNHANES 2016–2023 with available random urine Na and K results. Annual urinary Na/K ratios were calculated, and the prevalence of ratios ≥2 and ≥4 was assessed by age and sex using sampling weights. Results: The weighted median Na/K ratios were consistently lower than the weighted means, indicating skewed distributions. From 2016 to 2023, the weighted median and mean values increased from 2.3 and 2.7 to 2.8 and 3.3, respectively. The prevalence of a Na/K ratio ≥2 increased from 60.5% to 72.0%, and that of a ratio ≥4 increased from 16.9% to 28.3%. A U-shaped trend in Na/K ≥4 prevalence was observed by age, highest among those <20 and ≥70 years. Males had a higher prevalence than females in all age groups except 20–29. Conclusions: A growing proportion of Koreans exceeded Na/K cutoffs of 2 and 4 over time. Age- and sex-specific variation suggests tailored interpretation may be necessary when applying these thresholds in population health monitoring. Full article