Search Results (4,344)

Background: Nutrition problems among primary school children increase the risk of illness, reduce school attendance, and impair academic performance. The Indonesian national school feeding program (ProGAS—Program Gizi Anak Sekolah) was developed to address these issues through the provision of healthy breakfast, nutrition education, and character building. Methods: This study employed a mixed-methods design involving 454 primary school students aged 8–14 years from 24 schools across four provinces. Data collection included structured questionnaires, 24 h dietary recalls, and anthropometric measurements. In-depth interviews with school principals, teachers, cooking teams, parents, students, nutritionists, and district education office staff were conducted to capture experiences and opinions on the ProGAS implementation. Results: ProGAS significantly improved students’ dietary diversity, meal frequency, handwashing with soap, and nutrition knowledge, alongside a positive trend in school attendance. Improvements included higher mean dietary diversity, increased proportion of students eating ≥3 meals/day, greater correct responses on balanced nutrition, and higher rates of handwashing before meals (all p < 0.01). Children also developed positive behaviors such as praying before meals, queuing, and taking responsibility for cleaning dishes. However, students’ breakfast habits did not significantly improve, the delivery of nutrition education was suboptimal, and no significant changes were observed in nutrient intakes or nutritional status based on BMI-for-age. While the energy and protein contributions of the ProGAS menu met the recommended 25–30% of daily requirements for breakfast, its micronutrient contributions remained below the recommended levels. Key management gaps include the delivery of nutrition education to students and the monitoring of implementation by local and national authorities. Conclusions: ProGAS demonstrated positive impacts on some dietary and hygiene practices as well as learning environment. To achieve greater improvements in breakfast habits, nutrient intake and nutritional status, it is recommended to strengthen the school feeding menus not only for dietary diversity but also for nutrient density, enhance capacity building for teachers, deliver regular and engaging nutrition education, and reinforce program monitoring. Full article

Rice is a staple food for global nutrition, and its processing generates large volumes of waste with a consequent environmental impact. The industry needs to improve its capacity to manage and treat this waste with more sustainable options than traditional management methods, thereby mitigating the environmental impact of the rice industry. Among the waste streams generated, rice bran represents a significant fraction that is largely underutilized. This study proposes a comprehensive approach to rice bran recovery, aiming to transform 100% of the waste into bio-based products through a three-stage biorefinery approach that combines chemical and biological operations. The process began with the ethanolic extraction of rice bran, which yielded 20.58% (w·w⁻¹) rice bran oil. This oil, evaluated through both in vitro and in vivo trials, has demonstrated effectiveness when combined with commercial edible coatings, reducing post-harvest damage in grapes and lemons by 15–20%. Following extraction, the remaining defatted rice bran, accounting for 79.42% (w·w⁻¹) of the initial material, was used as a carbon-rich substrate for microbial fermentation by Haloferax mediterranei. This step converts 28.75% (w·w⁻¹) of rice bran into microbial biomass and 12.75% (w·w⁻¹) into polyhydroxybutyrate-valerate. The undigested residual biomass, comprising 37.95% (w·w⁻¹) of the starting material, was further valorized through the purification of high-value products such as cellulose (13.08% (w·w⁻¹)), hemicellulose (14.58% (w·w⁻¹)), and lignin (10.29% (w·w⁻¹)). Overall, the biorefinery model recovers 100% of the initial waste and demonstrates, under laboratory conditions, the model’s ability to transform rice bran into six products of industrial interest, offering an option with the potential to effectively manage rice bran waste and help circularize the production model of an industry that traditionally operates under a linear production model. Full article

Digestive enzymes play a crucial role in carbohydrate hydrolysis and subsequent glucose absorption, and their inhibition can contribute to improved glycemic regulation. Legumes, with their inherent enzyme-inhibitory properties, offer a natural approach for achieving this. In this study, accessions of M. uniflorum (Lam.) Verdc, an underutilized legume, were evaluated in vitro for their α-amylase and α-glucosidase inhibitory activities, as well as their protein, amylose, and resistant starch contents. The results revealed significant variation among the accessions. PI 174827 01 SD (IC₅₀ = 23.29 ± 0.01 µg/mL) and PI 173901 01 SD (IC₅₀ = 24.60 ± 0.01 µg/mL) demonstrated strong inhibition of α-amylase and α-glucosidase, respectively. Protein content ranged from 13.81 to 27.08%w/w d.w., with PI 180437 01 SD showing the highest percentage. Total starch content ranged from 27.48 to 54.70%w/w d.w., amylose from 27.05 to 48.13%w/w d.w., and resistant starch from 5.89% to 7.09%w/w d.w., with PI 174827 01 SD exhibiting both higher amylose and resistant starch contents. These findings suggest that M. uniflorum accessions possess enzyme-inhibitory and nutritional components that could be harnessed to develop functional foods, nutraceuticals, and pharmaceuticals for the management of diabetes and obesity. Full article

Background/Objectives: Colorectal cancer (CRC) accounts for nearly 10% of global cancer cases and is the second leading cause of cancer-related mortality. While age and genetics are non-modifiable risk factors, nutrition and its impact on gut microbiota are emerging as key determinants in CRC prevention and management. We aimed to systematically evaluate recent evidence on the role of diet and microbiota-targeted interventions—including probiotics, prebiotics, synbiotics, and postbiotics—in modulating CRC risk and therapeutic outcomes. Methods: A structured literature search was performed in PubMed, ResearchGate, Scopus, and ScienceDirect up to July of 2025. Reference lists of relevant reviews and clinical trials were also screened. A total of 36 studies were selected according to PRISMA guidelines. Data were extracted on dietary exposures, microbiota modulation, metabolite profiles, and CRC-related outcomes. Evidence quality was assessed using appropriate appraisal tools for observational and interventional designs. Results: Western-type diets were consistently associated with microbiota dysbiosis, the enrichment of pro-inflammatory and genotoxic taxa, and elevated CRC risk. Diets rich in fiber and polyphenols enhanced commensals producing short-chain fatty acids (e.g., butyrate), with anti-inflammatory and antineoplastic effects. Probiotics, prebiotics, and postbiotics demonstrated potential to restore microbial balance, improve epithelial integrity, and enhance tolerance to conventional therapies. Conclusions: Current evidence supports a complex interplay between nutrition, the gut microbiota, and CRC, with strong translational potential. Microbiota-modulating nutritional strategies, particularly fiber-rich diets and synbiotics, show the most consistent microbiota-related benefits in CRC prevention and represent promising adjuncts to standard therapies. However, much of the available research is still based on preclinical models. Therefore, there is a pressing need for well-designed clinical studies in human populations to validate these findings and inform evidence-based guidelines. Full article

Background/Objectives: Dyslipidemia is a global health concern. It refers to increased blood levels of LDL-C, triglycerides, and total cholesterol, accompanied by decreased blood HDL-C levels. Many pharmacological and non-pharmacological approaches have been designed to improve dyslipidemia management. However, nutritional therapies have gained more attention due to their antioxidant and anti-inflammatory properties. In this scenario, the carotenoid crocin stands out as a prominent anti-dyslipidemia phytochemical. Its unique structure permits lipid-lowering effects via various mechanisms, including the enhancement of lipid breakdown, reduction in lipid formation, bolstering of antioxidant defenses to diminish lipid toxicity, and decreased absorption of dietary fats. However, no recent systematic review or meta-analysis has addressed its anti-dyslipidemia effects with statistical power. Therefore, we aim to fill this gap with our current meta-analysis, as well as dose and time–response assessments. Methods: PubMed, SpringerLink, ScienceDirect, Cochrane, and Google Scholar databases were searched, and PRISMA guidelines were followed. Ten studies comprising eleven results were included. Results: Crocin did not improve LDL-C (0.2120, 95% CI: −0.0799 to 0.5040), HDL-C (−0.1937, 95% CI: −0.4896 to 0.1022), triglyceride (−0.2063, 95% CI: −0.5764 to 0.1638), or total cholesterol (0.1528, 95% CI: −0.1074 to 0.4129). The dose–response or time–response was also not statistically significant. Conclusions: More clinical studies with robust designs must be conducted to thoroughly assess crocin’s effectiveness in modulating lipid levels with the utmost care. Full article

Chronic anemia is commonly diagnosed in older adults and serves an important indicator of both reactive and clonal conditions. Many underlying diseases, such as myelodysplastic syndromes and multiple myeloma, are more prevalent amongst the elderly, while novel therapeutic approaches have transformed pediatric disorders of poor prognosis, such as beta-thalassemia, to a chronic disease of older adults. Thus, the increasing prevalence of chronic anemia in older ages is largely attributed to more frequent diagnostic and therapeutic evaluations and demographic changes. The etiology of anemia in adults is complex, ranging from genetic mutations to bone marrow failure syndromes, chronic kidney disease, nutritional deficiencies, and inflammatory processes, while in some cases no clear etiology is found. For this reason, extensive research is ongoing to introduce novel therapeutic targets and improve quality of life. Management of anemia in adults depends on severity and especially on the underlying conditions of each patient. Metabolic pathway analyses have revealed alterations in various pathways, including glycolysis, pyruvate, propanoate, glycerophospholipid, galactose, fatty acid, starch, and sucrose metabolism along with fatty acid elongation in mitochondria, glycerolipid, glyoxylate, and dicarboxylate metabolism in adult patients with chronic anemia compared to healthy individuals, which may serve as potential new therapeutic targets. In this review, we aim to (i) summarize current evidence regarding metabolic disturbances in diseases of age-related hematopoietic dysregulation, being represented by multiple myeloma and myelodysplastic syndromes, and in β-thalassemia, a disease model of accelerating cellular aging; and (ii) describe novel therapeutic metabolic-targeted options for the aforementioned diseases, focusing on the need for continuous research in this field. Full article

Background/Objectives: Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) that often requires long-term parenteral nutrition (PN). Extended PN results in severe complications and reduced quality of life (QoL). This study aimed to evaluate the QoL utility weights associated with PN duration using vignettes. Methods: We developed detailed scenarios and descriptions to represent eight hypothetical health states, reflecting variations in PN frequency in both pediatric and adult patients. A cross-sectional survey was conducted among 359 Korean adults (aged 19–59 years) from the general population, assigned to evaluate adult (n = 179) or pediatric (n = 180) vignette groups. Health utility was measured using the EuroQol 5-Dimension (EQ-5D), visual analog scale (VAS), and time trade-off (TTO) methods. Multivariable regression analysis using a mixed-effects model was employed to manage repeated measures and control for sociodemographic variables. Results: Utility scores measured using the EQ-5D, VAS, and TTO were negatively correlated with increasing PN days in both adult and pediatric patients with SBS-IF. The highest mean utility values were “0 days on PN” (adults: EQ-5D 0.808, VAS 0.689, TTO 0.874; pediatric: EQ-5D 0.804, VAS 0.680, TTO 0.883), while the lowest were “7 days on PN” (adults: EQ-5D 0.117, VAS 0.180, TTO 0.272; pediatric: EQ-5D 0.070, VAS 0.178, TTO 0.291). These trends remained significant after covariate adjustment (p < 0.001). Conclusions: The study revealed a steady decline in utility values with an increasing number of PN days. These findings highlight the importance of enhancing the QoL in patients with SBS-IF by supporting intestinal adaptation and reducing PN dependency. Full article

Background: Poor nutrition drives chronic disease, health disparities, and rising health care costs in the United States. Medically tailored meals (MTMs), designed by registered dietitians, are a Food-as-Medicine intervention with potential to improve outcomes and reduce costs. This review synthesizes evidence on the clinical, economic, and policy implications of MTMs. Methods: We conducted a narrative review of peer-reviewed studies, real-world program evaluations, and policy analyses. Sources included PubMed, Google Scholar, and grey literature from government, nonprofit, and industry organizations. Articles and reports were included if they examined MTMs in Medicare, Medicaid, or other high-risk populations. Results: Evidence demonstrates that MTMs improve health outcomes, reduce hospitalizations, and lower total cost of care. Case studies from Medicaid and Medicare Advantage plans, including those administered by Mom’s Meals^®, report reductions in emergency department visits, hospital readmissions, and total cost of care, alongside sustained high member satisfaction. Despite these findings, gaps in coverage and limited stakeholder awareness hinder broader access and adoption. Conclusions: Federal policy action can expand MTM availability and maximize utilization of existing benefits. Opportunities include establishing a Medicare Fee-for-Service demonstration, expanding and encouraging use in Medicare Advantage, and leveraging MTMs within Center for Medicare and Medicaid Innovation models. Broader implementation and utilization could reduce the nation’s chronic disease burden, advance health equity, and promote value-based care. Full article

Inflammatory Bowel Diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC), have become a growing global health concern in children and adolescents. Pediatric-onset IBD presents unique challenges compared with adult-onset forms, including more extensive disease, impaired growth, delayed puberty, and psychosocial difficulties. While biologic and targeted therapies have advanced disease control, nutritional interventions remain a central component of management. Exclusive enteral nutrition (EEN) is recognized as the first-line therapy for inducing remission in pediatric CD, offering comparable efficacy to corticosteroids with additional benefits for mucosal healing, nutritional status, and growth. Modified dietary approaches, such as partial enteral nutrition and the Crohn’s Disease Exclusion Diet (CDED), show promise for improving adherence and maintaining remission. However, dietary restrictions may lead to deficiencies and psychosocial stress, underscoring the importance of individualized, dietitian-supervised care. The role of nutrition in UC is less defined, but balanced, anti-inflammatory dietary patterns appear beneficial. This narrative review summarizes current evidence on nutritional strategies in pediatric IBD, highlighting their therapeutic potential, limitations, and integration with pharmacologic treatment within a multidisciplinary framework aimed at optimizing outcomes and quality of life. Full article

Stable pollination by honeybees (Apis mellifera L.) is essential for the reliable production of strawberries cultivated in winter greenhouses in Korea. Few studies focused on the management of pollination hives within greenhouses during flowering. Thus, this study aimed to investigate the effects of nutritional feed management by supplementing pollen patties and sugar solution on the pollination efficiency and colony longevity of honeybees under greenhouse conditions. In March, the number of foraging bees in the treatment group was 1.94 times higher than that in the control group. The number of bees inside the hive was approximately 2000 greater in February and approximately 2925 greater in March in the treatment group than in the control group. The pollen patties supplemented one time were completely consumed after 53 days, whereas 50% of the patties remained even after 70 days when supplemented three times. The commercial fruit set rate was 5.9% higher, and the fruit weight was significantly heavier, by 1.7 g, in the treatment group than in the control group, although other quality parameters showed no significant differences. Additionally, bee activity was approximately 2.2 times higher in the treatment group with sugar syrup supplementation than in the control group, but the fruit set rate or quality did not significantly differ between the two groups. These findings indicate that the feed management of honeybees during winter greenhouse strawberry cultivation is essential for stable pollination. Proper nutritional supplementation not only enhances bee activity and colony longevity but also improves strawberry productivity, leading to an estimated additional profit of approximately KRW 2.29 million (≈USD 1700) per 0.1 ha. This demonstrates that nutritional management of pollination hives provides both biological and economic benefits for greenhouse strawberry growers. Full article

Background and Clinical Significance: Zolbetuximab, a claudin 18.2-targeted monoclonal antibody, has demonstrated efficacy in advanced gastric cancer. Hypoalbuminemia has emerged as a notable adverse effect, but its underlying mechanism remains unclear. Case Presentation: A 53-year-old male with unresectable advanced gastric cancer received zolbetuximab-based combination therapy, achieving tumor regression enabling conversion surgery. During six cycles of treatment, serum albumin levels decreased from 4.3 g/dL to 3.5-3.6 g/dL (grade 1 hypoalbuminemia). A histopathological examination of the surgical specimen revealed hypertrophic gastritis characterized by marked foveolar hyperplasia, increased mucus secretion, and pyloric gland metaplasia on the lesser curvature. These findings suggest that zolbetuximab-induced mucosal alterations may contribute to hypoalbuminemia through enhanced protein loss. Conclusions: This is the first pathological documentation of hypertrophic gastritis associated with zolbetuximab therapy. Clinicians should monitor albumin levels during treatment and consider nutritional support when indicated. These findings provide important insights for optimizing patient management and ensuring safe conversion surgery planning. 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: Chronic kidney disease (CKD) requires strict dietary management tailored to disease stage and individual needs. Recent advances in artificial intelligence (AI) have introduced chatbot-based tools capable of generating dietary recommendations. However, their accuracy, personalization, and practical applicability in clinical nutrition remain largely unvalidated, particularly in non-Western settings. Methods: Simulated patient profiles representing each CKD stage were developed and used to prompt GPT-4 (OpenAI), Gemini (Google), and Copilot (Microsoft) with the same request for meal planning. AI-generated diets were evaluated by three physicians using a 5-point Likert scale across three criteria: personalization, consistency with guidelines, practicality, and availability. Descriptive statistics, Kruskal–Wallis tests, and Dunn’s post hoc tests were performed to compare model performance. Nutritional analysis of four meal plans (Initial, GPT-4, Gemini, and Copilot) was conducted using both GPT-4 estimates and manual calculations validated against clinical dietary sources. Results: Scores for personalization and consistency were significantly higher for Gemini and GPT-4 compared with Copilot, with no significant differences between Gemini and GPT-4 (p = 0.0001 and p = 0.0002, respectively). Practicality showed marginal significance, with GPT-4 slightly outperforming Gemini (p = 0.0476). Nutritional component analysis revealed discrepancies between GPT-4’s internal estimations and manual values, with occasional deviations from clinical guidelines, most notably for sodium and potassium, and moderate overestimation for phosphorus. Conclusions: While AI chatbots show promise in delivering dietary guidance for CKD patients, with Gemini demonstrating the strongest performance, further development, clinical validation, and testing with real patient data are needed before AI-driven tools can be fully integrated into patient-centered CKD nutritional care. Full article

Fresh lettuce is a key ingredient in ready-to-eat salads that are considered a valued dietary choice. Lettuce quality is strongly influenced by soil management practices, particularly in sustainable farming systems. This study evaluated the effects of three different soil disinfestation methods (flame weeding, microwave irradiation, and biological control (Trichoderma spp. inoculation) on the quality traits of Lactuca sativa L. var. Margò grown in a protected environment in southern Italy in a winter growth cycle. Minerals, nitrate content, colorimetric parameters, carotenoids, polyphenols, and antioxidant activity were assessed. The treatment with Trichoderma spp. significantly reduced nitrate accumulation (−21.3%) and increased some phenolic compounds and P (22%), while microwave irradiation treatment boosted total phenolic content by 44%. Flame weeding, although partially effective, was associated with a slight increase in carotenoids. Overall, microwave irradiation and Trichoderma spp. treatments emerged as the most promising options for balancing food safety and nutritional value. These findings offer valuable insights about the effect of soil disinfestation strategies on leafy vegetable quality. Full article

Adapting low-viscosity liquids for individuals with dysphagia presents persistent challenges in both texture modification and patient compliance. This exploratory study assessed the flow characteristics and nutritional contributions of 30 beverages (22 plant-based and 8 dairy-based) across different thickener concentrations and syringe models, following the International Dysphagia Diet Standardization Initiative (IDDSI) flow test. Flow measurements were obtained using four available 10 mL syringes that differed from the IDDSI-specified model, intending to evaluate their potential impact on results and inform strategies for situations where standard syringes are unavailable. Findings show that flow performance and IDDSI classification are strongly influenced by syringe design, thickener type, and beverage composition. The use of alternative syringes introduced variability in consistency measurements, highlighting the importance of equipment standardization. Interpretation of flow levels was further complicated by transitional IDDSI thresholds and subjective assessments. Nutritionally, the study reinforces the role of hydration in dysphagia management and explores the potential of plant-based beverages to enhance both fluid intake and fiber contribution. Several samples provided meaningful contributions to daily fiber and micronutrient requirements. Importantly, the study found that half the manufacturer’s recommended thickener dose was often sufficient to achieve IDDSI compliance. These findings support the practical use of non-standard syringes in IDDSI testing, inform more efficient thickening strategies, and highlight plant-based beverages as promising alternatives to dairy in dysphagia diets. Together, they offer actionable insights for improving consistency control and nutritional quality in dysphagia care. Full article