Search Results (4,118)

Background/Objectives: Micronutrient deficiencies are common in inflammatory bowel disease (IBD) and contribute to anemia, impaired wound healing, neurologic injury, and adverse disease outcomes. Major societies, including ESPEN, ACG, and ECCO, recommend nutritional and micronutrient assessment in patients with IBD, yet few studies describe how comprehensively these recommendations are applied during hospitalization. This study aimed to characterize inpatient testing practices for vitamins B1, B6, B12, and zinc in hospitalized IBD patients, quantify deficiency frequency among those tested, and identify gaps between guideline-recommended and actual micronutrient assessment. Methods: A retrospective chart review was performed on adults with Crohn’s disease (CD) or ulcerative colitis (UC) hospitalized for an IBD flare at a tertiary care center. Demographics, comorbidities, and deficiency-associated clinical features were recorded. Yield was defined as the proportion of tested patients meeting institutional deficiency thresholds. Yield for each non-B12 micronutrient was compared with B12 as an internal benchmark. Results: Among 356 patients (285 CD, 71 UC), inpatient micronutrient testing was markedly imbalanced: B12 was tested in 97.2%, whereas B6, B1, and zinc were tested in only 34.8%, 30.6%, and 18.8%, respectively. Among those tested, deficiencies were common: B6 40.3%, zinc 32.8%, B1 22.9%, and B12 9.0%. Each non-B12 micronutrient yielded deficiency significantly more often per test than B12 (all p < 0.001), a testing-yield mismatch interpreted cautiously given selective testing of non-B12 nutrients. Deficiency frequencies did not differ significantly between CD and UC. Clinical contexts included tachycardia and edema (B1); elevated inflammatory markers and thromboembolism history (B6); anemia and neuropathy (B12); and diarrhea and hypoalbuminemia (zinc). Conclusions: Inpatient micronutrient assessment in IBD is heavily skewed toward B12, with B1, B6, and zinc under-tested despite a substantially higher yield of identified deficiency per test. This testing-yield mismatch represents a measurable implementation gap between guideline-recommended comprehensive assessment and actual inpatient practice; whether systematic panel-based assessment improves clinical outcomes warrants prospective evaluation. Full article

Objectives: The objective of this cross-sectional online survey was to determine university students’ knowledge about whole grain (WG), sorghum, and prediabetes risk. Methods: The survey included 45 items to learn about the students’ WG perception, practices, primary nutrition information source, and physical activity level (PAL). Recruitment was carried out using the university’s official email announcement and data was collected through Qualtrics. Two-hundred-and-forty-eight undergraduate and graduate students, aged 18–44 years, completed the questionnaire. Results: Sixty-three percent of the students were at risk of prediabetes based on the CDC Prediabetes Risk Test, a recommended screening tool by the National Diabetes Prevention Program. Compared to females, males were at a significantly higher risk of prediabetes and T2DM. Males had a mean ± sd score of 1.70 ± 0.93 versus females (0.64 ± 0.92), (t(246) = −9.07, p < 0.001). Participants scored low on overall knowledge (sorghum and WG combined) (4.21 ± 2.04), WG knowledge (2.82 ± 1.03) and sorghum knowledge (3.21 ± 1.23). Despite reporting a high PAL, less than half had a very good health status, with 45.2% of them having overweight or obesity. Social media was the main nutrition information source for 60% of participants. Logistic regression showed that students with obesity had almost four times greater odds compared to those with normal weight (OR = 3.97, 95% CI: 1.66–9.45, p = 0.002). Conclusions: These results have important public health implications, providing the rationale for our future research on a theory-based nutrition education intervention emphasizing sorghum consumption and metabolic effects on individuals with overweight and obesity, aiming to combat diet-related diseases. Full article

Background/Objectives: Low-protein diets (LPD) and very-low-protein diets supplemented with Ketoanalogues (sVLPD) delay initiation of dialysis in non-diabetic patients with chronic kidney disease (CKD). sVLPD is not recommended in patients with type 2 diabetes mellitus (T2DM), and information about LPD supplemented with Ketoanalogues (LPD + KA) is scarce or inconclusive. The objective of this study is to provide further evidence on the benefits and safety of LPD supplemented with KA (LPD + KA) compared with LPD alone in reducing CKD progression in patients with T2DM. Methods: T2DM patients in stages 3b-4 of CKD (n = 149) were included in a multicenter, randomized, controlled trial and received LPD + KA or LPD, 1 year follow-up. Evaluations were carried out bimonthly. In both groups, protein intake was 0.6 g/kg/day, and the LPD + KA group received KA at the recommended dose. The primary outcome was a decline in eGFR, calculated with Creatinine and with Cystatin C. Secondary outcomes were dialysis requirement, deterioration in nutritional status, hospitalization, morbidity, and mortality. Results: During follow-up, protein nitrogen appearance was 0.556 ± 0.119 and 0.576 ± 0.134 g/kg/day in LPD + KA and LPD, respectively (p = 0.002). The decrease in eGFR_CysC from the baseline was −4.29 ± 0.96 mL/min in LPD + KA and −8.54 ± 2.19 mL/min in LPD (using linear mixed-effects model, p = 0.012). eGFR_Cr did not show differences. There were no differences in nutrition status, metabolic control, adverse events, hospitalizations, or hospital days. Conclusions: Ketoanalogues slow the decline in eGFR_CyC but not eGFR_Cr in T2DM patients, even without differences in protein intake. LPD + KA may be considered useful and safe; however, due to limitations in sample size and follow-up, as well as observed changes in Cr metabolism, the results warrant confirmation with a more robust design and a longer follow-up period. Full article

Background/Objectives: Patients with inflammatory bowel disease (IBD) frequently experience food-related symptoms and express a strong need for dietary guidance, yet evidence-based recommendations remain limited. This often leads to self-imposed dietary restrictions, potentially compromising nutritional intake and food-related quality of life (Fr-QoL). The primary aim of this study was to evaluate changes in Fr-QoL, following personalized feedback on an IBD-specific food frequency questionnaire and access to an online nutritional knowledge portal over a 6-month period. Secondary exploratory outcomes included changes in dietary intake and diet quality. Methods: In this nationwide pre–post study, 108 patients with IBD completed baseline and 6-month assessments. Dietary intake was measured using the validated GINQ-FFQ and Fr-QoL using a 29-item questionnaire. Nutrient intake was compared with EFSA reference values. Participants received automated personalized feedback and had access to educational tools and dietitian resources. Changes over time were analyzed using paired statistical tests. Results: A significant improvement in Fr-QoL was observed (mean difference 8.1 points, 95% CI 5.5–10.7; p < 0.001; Cohen’s d = 0.39). Baseline intake was characterized by high fat and low fiber consumption. After 6 months, total energy intake decreased (p < 0.001), along with reductions in protein, fat, carbohydrates, fiber, and several micronutrients, including iron, folate, vitamin B6, vitamin C, potassium, magnesium, and zinc. Diet quality did not improve, and adherence to EFSA guidelines remained suboptimal. The digital tools were positively evaluated. Conclusions: In this single-arm pre–post study, Fr-QoL scores were higher at follow-up than at baseline among participants who completed both assessments, whereas dietary intake and overall diet quality did not improve. The findings support the feasibility and acceptability of the developed digital tools for dietary assessment and nutrition education, although their effectiveness requires further evaluation in controlled studies. Additional strategies, including structured dietitian-led support combined with digital resources, may be required to optimize nutritional outcomes in patients with IBD. Full article

The study evaluated the effects of corn grain deterioration under different storage conditions in processed feeds and broiler digestibility. The corn grains were stored in chambers (quality corn and contaminated corn) at different storage temperatures and relative humidity (10 °C and 90%, 30 °C and 40%), and the evaluations were carried out at five storage times (zero, three, six, nine, and twelve months). After feed formulation (zero, six, and twelve months of corn stored), the broilers (504 animals) were fed for up to 14 days. The excreta collection was done twice per day for metabolism analysis. The 10 °C and 90% RH conditions influenced the loss of dry matter; the physical quality of corn grain was lower for the 30 °C and 90% RH conditions. When we obtained lower dry matter losses, the microbiological and mycotoxin levels were directly influenced by the loss of dry matter in corn. The storage time increased the risk of fungi (8.5 × 10⁷ CFU g⁻¹), bacteria (7.5 × 10⁶ CFU g⁻¹), and aflatoxins (64.96 µg kg⁻¹), reaching levels above acceptable limits for the corn quality and interfering with digestibility and animal metabolism. In addition, the storage time was the determining factor in the nutritional loss of corn quality, feed, and animal digestibility. Furthermore, the storage time reduced the levels of crude protein (5%), gross energy in the feed (3200 kcal kg⁻¹), metabolizable energy (3000 kcal kg⁻¹), and animal digestibility (3100 kcal kg⁻¹) after six months of storage. Based on the results of this study, the feed processing industry should pay close attention to the origin of stored corn and the associated environmental conditions, as these factors led to significant changes in grain quality, directly impacting animal nutrition and production. Therefore, it is recommended that the production chain invest more in the sector—specifically in adequate infrastructure and grain storage monitoring and control systems—to provide higher-quality raw materials to the processing industry. Full article

Resveratrol is a plant-derived stilbene polyphenol that has attracted interest as a potential dietary additive for improving edible fish muscle quality. This review summarizes current evidence on pre-harvest dietary resveratrol supplementation and its possible effects on nutritional composition, flavor-related biochemical traits, and physicochemical quality of fish muscle or fillets. We distinguish nutritional quality, including proximate composition, amino-acid profiles, and fatty-acid composition, from flavor-related and sensory-relevant proxies, such as free amino acids, inosine monophosphate, volatile precursors, color, pH, water-holding capacity, and texture. Direct evidence from edible fish muscle remains limited and fragmented, and most available studies rely on biochemical or instrumental endpoints rather than trained-panel sensory evaluation or consumer acceptance testing. Reported effects suggest species- and dose-dependent changes in muscle protein deposition, amino-acid accumulation, fatty-acid composition, pH, cooking or drip loss, and texture-related traits. Putative mechanisms may involve antioxidant protection, muscle fiber remodeling, lipid metabolism, endoplasmic-reticulum stress, and delivery-dependent bioavailability; however, many mechanistic links are still inferred from hepatic tissues, mammalian models, or in vitro systems. Future studies should combine standardized dose–response feeding trials with gas chromatography–mass spectrometry (GC–MS)-based volatile profiling, lipid and protein oxidation indices, instrumental texture analysis, sensory evaluation, and shelf-life testing before resveratrol can be recommended as a robust feed-based strategy for improving edible fish muscle quality. Full article

Background: The relationships of different physical activity domains [e.g., Occupation-related Physical Activity (OPA), Transportation-related Physical Activity (TPA), and Leisure-time Physical Activity (LTPA)] with sleep disorders (SD) remain poorly elucidated. This study investigated the associations of OPA, TPA, and LTPA with SD in American adults. Methods: Data were derived from 25,732 adults with a mean (standard deviation) age of 49.72 (17.53) years (12,692 male and 13,040 female) participating in the 2007–2018 cycles of the National Health and Nutrition Examination Survey (NHANES). The PA domains were assessed using the Global Physical Activity Questionnaire (GPAQ), and adherence to PA recommendations was determined according to the 2018 PA guidelines. SD were identified by self-reported or doctor-diagnosed questionnaire items. Survey-weighted logistic regression models were applied to evaluate the associations between PA domains and SD, and restricted cubic spline (RCS) analyses were conducted to examine potential nonlinear associations. Results: In the fully adjusted model, total PA was not significantly associated with SD (OR 1.01, 95% CI 0.89–1.13, p = 0.912). Regarding specific PA domains, TPA was associated with lower odds of SD (OR 0.79, 95% CI 0.67–0.93, p = 0.006), whereas OPA was associated with higher odds of SD (OR 1.15, 95% CI 1.02–1.30, p = 0.023). No significant association was observed between LTPA and SD (OR 0.96, 95% CI 0.85–1.09, p = 0.511). The multivariable-adjusted RCS analysis further indicated significant nonlinear associations between PA domains and SD (all p for non-linear <0.001). Conclusion: Our findings underscore a prominent “PA paradox” in sleep health among US adults, suggesting that active commuting (TPA) exerts a protective role against SD, whereas OPA serves as a potential behavioral risk factor. Future longitudinal studies and objective PA measurements are needed to validate these cross-sectional associations. Full article

Background/Objectives: Hereditary fructose intolerance (HFI) is a rare autosomal recessive metabolic disorder caused by variants in the ALDOB gene, resulting in aldolase B deficiency. Symptoms occur after the ingestion of fructose, sucrose, or sorbitol, leading to metabolic toxicity. Management is exclusively dietary, but clinical practice remains highly variable. This survey aimed to investigate current Italian dietary management practices for patients with HFI. Methods: A cross-sectional centre-level survey was conducted using a 29-item questionnaire distributed to metabolic dietitians within the Italian Society for the Study of Inherited Metabolic Diseases network between April and May 2026. Results: Data from 27 dietitians across 15 Italian inherited metabolic disease centres were analysed. Over half of the centres (53.3%) provided care for both paediatric and adult patients, and all centres (100%) supplied structured educational materials for the fructose-, sucrose-, and sorbitol-restricted diet. Marked heterogeneity was observed in dietary practices, particularly in the classification of sugars and sweeteners, recommendations for cereal-based products, and fibre supplementation strategies. Cereal-based dietary guidance was provided by 10/15 centres (66.7%), ranging from no specific recommendations (5/15, 33.3%) to a preference for refined grains (7/15, 46.7%) or fibre-based restrictions (2/15, 13.3%). With regard to sugars and sweeteners, consensus was observed only for maltitol and sorbitol, which were classified as prohibited by all centres (15/15, 100%). Mannitol and isomalt were prohibited in 14/15 centres (93.3%). All other compounds showed variable recommendations across centres, including xylitol (prohibited 46.7%, permitted 40.0%), erythritol (permitted 60.0%), and sucralose (prohibited 33.3%, permitted 20.0%, restricted 20.0%, unspecified 26.7%). Vitamin C (100%) and folic acid (86.6%) were the most commonly prescribed supplements. One-third (33%) of the centres required the use of fibre supplements or osmotic laxatives to manage chronic constipation, with wide variability in the specific type of fibre recommended. Conclusions: These findings highlight substantial heterogeneity in dietary management of HFI across specialised Italian centres and support the development of evidence-based, standardised nutritional guidelines to improve the consistency of care, nutritional adequacy, and patient outcomes. Full article

Background: Donor human milk (DHM) is recommended when the mother’s own milk (MOM) is unavailable for extremely low birth weight (ELBW) infants. However, the impact of DHM implementation on NICUs with already high human milk utilization remains incompletely characterized. Objective: We aimed to evaluate the association between DHM implementation and feeding practices, feeding progression, parenteral nutrition (PN) exposure, and major neonatal morbidities in ELBW infants. Methods: We conducted a retrospective before–after cohort study in a single tertiary NICU including 116 ELBW infants with feeding data through day 28 (58 pre-DHM; 58 post-DHM). Exploratory multivariable models evaluated factors associated with NEC and PN duration. Results: In the post-DHM epoch, enteral feeding was initiated earlier (2 vs. 2.5 days, p < 0.001) and full enteral feeding was achieved sooner (14 vs. 24.5 days, p < 0.001). PN duration was numerically shorter (17.5 vs. 27 days, p = 0.088). Feeding shifted from predominantly exclusive MOM to mixed MOM + DHM regimens, eliminating formula-only feeding. NEC, feeding intolerance, bloodstream infection, and mortality did not differ between epochs. Feeding intolerance was associated with NEC, whereas lower gestational age predicted longer PN duration; epoch was not independently associated with either outcome. Conclusions: In this high-MOM NICU, DHM implementation was associated mainly with earlier feeding progression and reduced formula reliance, without a measurable reduction in NEC. Full article

Malnutrition, a key factor in oncology, affects 20–70% of cancer patients and influences both cancer risk and outcomes, being linked to decreased treatment tolerance, higher toxicity, lower quality of life, and shorter survival. Although international guidelines recommend early and systematic nutritional screening, its adoption in clinical practice remains inconsistent. This study, promoted by the Italian College of Hospital Medical Oncology Directors (CIPOMO), aimed to provide a national snapshot of current organizational practices regarding nutritional screening, assessment, and management in Italian oncology centers. A 15-item survey was sent to 165 centers to investigate organizational practices and awareness of nutrition and physical activity in cancer care. Data were collected and analyzed as overall percentages. A total of 100 centers responded (61%). Although a nutritional assessment is routinely conducted at diagnosis in 67% of centers (n = 67), only 31 centers perform it for all patients. The remaining centers limit nutritional assessment to high-risk or selected patient groups. Moreover, although 86% of centers have dedicated professionals, multidisciplinary integration remains limited. Validated nutritional screening tools are used in 69% of centers, but follow-up reassessment is rarely systematic (15%). However, awareness of the importance of nutrition is high, with nearly all centers supporting educational interventions and dedicated nutritional pathways. Despite this high level of awareness, a significant gap remains between guideline recommendations and daily clinical practice. Standardizing early nutritional screening, enhancing multidisciplinary collaboration, and ensuring equitable and consistent access to nutritional services are crucial to fully integrating nutrition into oncology care and improving patient outcomes. Full article

Pumpkin leaves (Cucurbita maxima L.) are an underutilized leafy vegetable that represents a rich source of nutrients and bioactive compounds. This study assessed the effects of four common household cooking methods—boiling, steaming, microwaving, and stir-frying—on the nutrient composition, amino acid profile, phenolic compounds, carotenoids, antioxidant potential, antinutritional factors, and α-amylase inhibitory activity of young pumpkin leaves. Steaming resulted in the highest apparent retention of phenolics, flavonoids, and carotenoids. Microwave treatment also maintained relatively high levels of phytochemicals, whereas boiling caused the greatest losses of bioactive compounds. Steaming also showed the strongest α-amylase inhibitory activity. Boiling, on the other hand, was the most effective method for reducing antinutritional compounds. The results demonstrate that culinary processing significantly affects the nutritional and functional quality of pumpkin leaves. Collectively, the results suggest that steaming was the most effective method for preserving nutrients and bioactive compounds, whereas boiling was more effective in reducing antinutritional compounds. These findings provide practical evidence-based recommendations for optimizing household cooking methods according to specific nutritional objectives. Full article

Despite the potential of Eragrostis nigra in alleviating forage shortages and controlling soil erosion, there is little information about how nitrogen fertilization and row spacing affect its forage and seed production. Thus, a two-year field experiment was conducted to explore the effects of nitrogen (N) fertilization (0, 45, 90, 135 kg hectare⁻¹ (ha⁻¹)) and row spacing (20 cm, 40 cm) on its forage yield, nutritive value, seed yield and quality. Results showed that forage dry matter yield (DMY) and harvested seed yield (HSY) increased with higher N rates; however, no further enhancement was observed at 135 kg per ha⁻¹, making 90 kg ha⁻¹ optimum. This may be because excessive nitrogen disrupts the carbon–nitrogen metabolic balance. N fertilization increased the relative feed value by enhancing crude protein content and decreasing acid detergent fiber. Relative to the 20 cm spacing, the 40 cm spacing averagely raised PSY and HSY by 34.7% and 21.3%, respectively. The quadratic regression model yielded maximum predicted HSY values of 27.6 and 26.7 kg ha⁻¹, achieved at optimal N rates of 135 and 98.6 kg ha⁻¹ for the 20 cm and 40 cm spacings, respectively. Thousand-seed weight (TSW), germination index, and vigor index were significantly improved by row spacing and N application (p < 0.05). Seed yield enhancement from N was positively correlated with increases in number of fertile tillers (FT), number of spikelets per tiller and seed set (p < 0.05). Furthermore, FT and TSW had the strongest direct effects on seed yield, with standardized path coefficients of 0.362 and 0.390. Our findings highlight that an application rate of 90 kg ha⁻¹ N combined with 40 cm row spacing could be recommended as the efficient agronomic practice for maximizing forage yield, nutritive value, and seed yield in E. nigra. Importantly, this regime also enhances economic returns while reducing N leaching risks, thereby supporting more sustainable forage production systems. Full article

The treatment of osteoarthritis (OA), a leading cause of disability worldwide, is increasingly integrating nutritional strategies that appear to offer the opportunity to significantly improve the quality of care. Patients are also aware of this and often seek clarification and advice from OA professionals. However, it is still too early to formulate definitive recommendations, as the scientific evidence is still heterogeneous. This can create a gap between patients’ need for clear guidance and the necessarily prudent communication of professionals. As a result, some patients may make decisions on their own, forgoing the opportunity to receive nutritional care personalised according to their dietary habits and disease severity. This commentary presents an expert interpretation of the currently available evidence and proposes a practical framework to support clinical discussions with patients. It is not intended as a formal clinical practice guideline but aims to help OA professionals navigate conversations about the role that nutritional strategies may play in disease management. Full article

The integration of precision nutrition with pharmacological therapies has been proposed as a strategy to optimize therapeutic efficacy, tolerability, and patient-centered outcomes in chronic metabolic diseases. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have substantially advanced the treatment of obesity and type 2 diabetes mellitus by promoting substantial weight loss and improving glycemic control and cardiometabolic risk profiles. However, significant interindividual variability in therapeutic response, frequent gastrointestinal adverse events leading to treatment discontinuation, and the potential loss of lean body mass remain major clinical challenges that limit real-world therapeutic efficiency. Emerging evidence suggests that nutritional status, dietary patterns, body composition, inflammatory burden, and gut microbiota composition may influence both the efficacy and tolerability of GLP-1-based therapies. This review explores the role of precision nutrition as an adjunctive strategy to support GLP-1 RA treatment outcomes through personalized dietary interventions and targeted nutritional support. Particular attention is given to protein intake optimization for lean mass preservation, micronutrient adequacy, microbiota modulation, anti-inflammatory dietary approaches, and the management of gastrointestinal symptoms. Furthermore, the review explores the emerging contribution of nutrigenomics, metabolomics, microbiome-based stratification, digital health technologies, and artificial intelligence in advancing pharmacometabolic personalization. The potential pharmacoeconomic implications of integrated nutritional–pharmacological strategies are discussed, including the potential for improved adherence to reduce treatment-related costs, prevent complications, and enhance long-term metabolic sustainability. While current evidence supports the mechanistic rationale for combining precision nutrition with GLP-1 receptor agonist therapy, it must be emphasized that direct evidence from prospective clinical trials evaluating such integrated strategies is limited. Most recommendations are based on indirect evidence from general weight-loss or metabolic disease populations, and their efficacy, specifically in GLP-1 RA-treated patients, remains to be demonstrated. Full article

Background/Objectives: Exercise-induced muscle damage, inflammation, oxidative stress, and accumulated fatigue affect post-exercise recovery and long-term training adaptations in athletes. Consequently, nutritional strategies supporting recovery have gained attention in sports nutrition. Among emerging compounds, adaptogens have attracted particular interest due to their potential anti-fatigue, antioxidant, and sleep-enhancing properties. However, evidence in trained athletes remains limited. Therefore, the aim of this narrative review is to summarize the current scientific evidence regarding the use of selected adaptogens in sport and to evaluate their potential roles in exercise recovery, training adaptation and exercise performance. Particular attention is given to Withania somnifera (ashwagandha), Panax species, Rhodiola rosea and Cordyceps species. Furthermore, this review discusses the practical implications and current limitations of the available evidence for athletes and sports practitioners. Conclusions: Current evidence from a limited number of heterogeneous studies suggests that selected standardized adaptogen preparations may provide beneficial effects on specific exercise-recovery-related outcomes and selected aspects of exercise performance in trained athletes. Among the adaptogens discussed, most consistent evidence concerns Withania somnifera, whereas the evidence for Panax species, Rhodiola rosea and Cordyceps species remains limited and should be considered preliminary. Furthermore, the available literature is characterized by a limited number of studies conducted in trained athletes, the underrepresentation of female athletes, and considerable heterogeneity in extract composition and supplementation protocols. Consequently, the current evidence is insufficient to formulate definitive recommendations regarding the efficacy, optimal dosage, or long-term safety of adaptogen supplementation. Further well-designed randomized controlled trials are required to establish evidence-based recommendations. Full article