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20 pages, 4234 KB  
Article
Different Temperature Storage Conditions and Packaging Types Affects Colour Parameters, Amino Acid Composition, Microbial Contamination, and Key Bioactive Molecules of Moringa oleifera Lam. Powder
by Ashwell R. Ndhlala, Gladness T. Ngobeni, Rofhiwa Mulaudzi and Sogolo L. Lebelo
Molecules 2025, 30(20), 4048; https://doi.org/10.3390/molecules30204048 (registering DOI) - 11 Oct 2025
Abstract
Moringa oleifera, renowned for its medicinal potency, was investigated to discern the impact of varying storage temperatures (4 °C, 25 °C, 40 °C) and light conditions (dark and light) on the quality attributes of its leaf powder during a 12-month storage period. [...] Read more.
Moringa oleifera, renowned for its medicinal potency, was investigated to discern the impact of varying storage temperatures (4 °C, 25 °C, 40 °C) and light conditions (dark and light) on the quality attributes of its leaf powder during a 12-month storage period. The study encompassed comprehensive analyses of phytochemical levels, nutritional properties, microbial contamination, and colour changes in response to these diverse storage environments. The lightness L* colour value changed significantly (40 to 60) from baseline tests when stored at 40 °C in transparent packaging. Results highlighted distinct variations in phytochemical composition and nutritional content based on the interplay between temperature and light conditions. Lower temperatures, particularly 4 °C, in both dark and light environments, demonstrated superior preservation of bioactive compounds, with mean values for quercetin-3-rutinoside of 3.34 µg/g and 3.19 µg/g, respectively; both are significantly higher compared to other treatments (p < 0.05). This trend was also observed for rutin, chlorogenic acid, and quercetin. Conversely, higher temperatures (25 °C, 40 °C) coupled with light exposure hastened degradation, notably impacting phytochemical stability. Microbial proliferation was evident in elevated temperatures, indicating potential safety risks. Further observations unveiled significant colour changes within the leaf powder, notably influenced by storage temperatures and light exposure. Lower temperatures exhibited diminished colour alterations compared to higher temperatures, underscoring their impact on product quality. This study underscores the critical role of controlled storage conditions, especially cooler temperatures and reduced light exposure, in maintaining the potency and quality of M. oleifera leaf powder. Recommendations advocate for stringent temperature control (preferably 4 °C) and light shielding during storage to uphold phytochemical stability and mitigate microbial proliferation. While this study provides valuable insights into temperature-mediated alterations, future research avenues should delve deeper into elucidating the underlying mechanisms of colour changes and long-term temperature effects on phytochemical and nutritional integrity. Full article
(This article belongs to the Special Issue Bioactive Compounds from Foods for Health Benefits)
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22 pages, 2323 KB  
Article
Effects of Asparagus Powder Supplementation on Glycemic Control, Lipid Profile, and Oxidative Stress in Overweight and Obese Adults: An Exploratory Randomized Controlled Trial
by Jittima Mongraykang, Tadsawiya Padkao, Orachorn Boonla, Yothin Teethaisong, Thapanee Roengrit, Sukrisd Koowattanatianchai and Piyapong Prasertsri
Life 2025, 15(10), 1584; https://doi.org/10.3390/life15101584 (registering DOI) - 10 Oct 2025
Abstract
This study investigated the effects of asparagus powder supplementation on blood glucose regulation, insulin, lipid profile, and oxidative stress in overweight and obese individuals. Forty-four adults aged 18–59 years participated in a 12-week randomized controlled trial and were randomly assigned to receive either [...] Read more.
This study investigated the effects of asparagus powder supplementation on blood glucose regulation, insulin, lipid profile, and oxidative stress in overweight and obese individuals. Forty-four adults aged 18–59 years participated in a 12-week randomized controlled trial and were randomly assigned to receive either asparagus powder (40 mg/kg/day) or a placebo (maltodextrin, 40 mg/kg/day). Assessments included an oral glucose tolerance test (OGTT), fasting blood glucose (FBG), insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and β-cell function (HOMA-B), lipid profile, and oxidative stress markers (malondialdehyde [MDA], protein carbonyl, and superoxide dismutase [SOD]). In the asparagus group, OGTT at 30 min and low-density lipoprotein cholesterol (LDL-C) significantly decreased, while SOD activity significantly increased (all p < 0.05). In contrast, the placebo group showed significant increases in OGTT at 30 min, insulin, HOMA-IR, HOMA-B, triglycerides (TG), the TG/high-density lipoprotein cholesterol (HDL-C) ratio, and the total cholesterol (TC)/HDL-C ratio (all p < 0.05). Between-group comparisons indicated that FBG, area under the BG curve at 30–120 min, TG, TG/HDL-C, and MDA levels were significantly lower in the asparagus group than in the placebo group (all p < 0.05), whereas OGTT, LDL-C, SOD activity, insulin, HOMA-IR, HOMA-B, and TC/HDL-C did not differ significantly. Other indices, including TC, HDL-C, and protein carbonyl, showed no significant within- or between-group differences. In conclusion, 12 weeks of asparagus powder supplementation partially improved glycemic control, lipid profile, and oxidative stress in overweight and obese individuals. These findings suggest a potential role of asparagus as a complementary nutritional strategy to reduce the risk of diabetes and cardiovascular disease in this population. Full article
(This article belongs to the Special Issue Therapeutic Potential of Natural Products in Chronic Diseases)
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11 pages, 442 KB  
Article
Integrating Nutrition, Inflammation, and Immunity: The CALLY Index as a Novel Prognostic Biomarker in Acute Geriatric Care
by Francesca Mancinetti, Anna Giulia Guazzarini, Martina Gaspari, Michele Francesco Croce, Rocco Serra, Patrizia Mecocci and Virginia Boccardi
Nutrients 2025, 17(20), 3192; https://doi.org/10.3390/nu17203192 - 10 Oct 2025
Abstract
Background/Objectives: Malnutrition, systemic inflammation, and immune dysfunction are key determinants of adverse outcomes in older adults following acute illness. Composite biomarkers integrating these domains could enhance early risk stratification. This study investigates, for the first time in acute geriatric care, the prognostic value [...] Read more.
Background/Objectives: Malnutrition, systemic inflammation, and immune dysfunction are key determinants of adverse outcomes in older adults following acute illness. Composite biomarkers integrating these domains could enhance early risk stratification. This study investigates, for the first time in acute geriatric care, the prognostic value of the C-reactive protein–albumin–lymphocyte (CALLY) index—a composite marker of nutritional, inflammatory, and immune status—in predicting short-term survival. Methods: We retrospectively analyzed 264 patients admitted to the acute geriatrics ward of Santa Maria della Misericordia Hospital in Perugia. The CALLY index was calculated as: (Albumin × Lymphocytes)/(CRP × 104). The optimal prognostic cut-off was determined using receiver operating characteristic (ROC) curve analysis. Three-month survival was assessed by Kaplan–Meier analysis. Results: The cohort included 167 women (63.3%) and 97 men (36.7%), with a mean age of 88.0 ± 6.4 years. At 3-month follow-up, 80 patients (30.3%) had died. The CALLY index showed an area under the ROC curve of 0.647 (95% CI: 0.576–0.718; p < 0.001), with a cut-off of 0.055 (sensitivity: 68.5%, specificity: 46.3%). Among deceased patients, 42.5% had a CALLY index <0.055. After multivariable adjustment, a lower CALLY index remained independently associated with increased mortality (B = −0.805; OR = 0.45; 95% CI: 0.215–0.930; p = 0.031). Kaplan–Meier analysis demonstrated significantly higher survival in patients with a CALLY index ≥ 0.055 (Log-rank test: 13.71; p < 0.001). Conclusions: The CALLY index shows a modest but statistically significant discriminative ability for predicting short-term mortality in acutely ill older adults. As a simple, low-cost marker derived from routine laboratory tests, it holds potential for integration into clinical workflows to guide nutritional, metabolic, and prognostic management strategies in geriatric acute care. Full article
(This article belongs to the Special Issue Nutritional Support for Critically Ill Patients)
22 pages, 3301 KB  
Article
Analysis of Factors Affecting Consumers’ Perception of Food Safety Risks in the Prepared Food Market
by Cong Shen, Wenyuan Meng, Xue Chen, Kexin Liu, Xinyao Wu and Qinhe Yu
Foods 2025, 14(20), 3463; https://doi.org/10.3390/foods14203463 - 10 Oct 2025
Abstract
The prepared food market has undergone significant growth in response to the contemporary fast-paced lifestyle. This growth has resulted in recurring safety concerns, which have diminished consumer confidence and hindered the industry’s expansion. Analyzing the factors affecting the perceived safety risk of prepared [...] Read more.
The prepared food market has undergone significant growth in response to the contemporary fast-paced lifestyle. This growth has resulted in recurring safety concerns, which have diminished consumer confidence and hindered the industry’s expansion. Analyzing the factors affecting the perceived safety risk of prepared food is essential in this context. This study utilizes consumers of prepared food in Zhengzhou, a newly designated first-tier city in China, as survey participants. This study constructs a research model based on 585 valid questionnaires to systematically investigate the key factors influencing consumers’ perceived risk regarding the safety of prepared food. The findings indicated that perceived risk was adversely affected by the nutritional balance, technical safety, and governance trust. The nutritional balance influences perceived risk indirectly through its impact on technical safety. Governance trust plays a moderating role between technical safety and perceived risk. The higher the governance trust, the stronger the impact of technical safety on reducing perceived risk. This study serves as a valuable resource for governmental oversight and the expansion of prepared food enterprises. Businesses can enhance technical safety, optimize product composition, and cultivate customer trust. To promote sustainable growth in the prepared food industry, the government can improve industry standards and strengthen oversight. Full article
(This article belongs to the Section Food Quality and Safety)
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15 pages, 558 KB  
Article
Benefits and Trade-Offs of Long-Term Organic Fertilization Substitution: Wheat Grain Nutrition and Heavy Metal Risks in an 11-Year Field Trial
by Yumin Liu, Xiaolin Zhou, Zishuang Li, Lei Ma, Yan Li, Huanyu Zhao, Yu Xu and Deshui Tan
Agronomy 2025, 15(10), 2369; https://doi.org/10.3390/agronomy15102369 - 10 Oct 2025
Abstract
Optimizing organic fertilizer substitution is essential for enhancing the sustainability of agriculture and achieving a balance between crop productivity, nutritional quality, and environmental safety. Here, we conducted an 11-year field experiment to evaluate the effects of substituting 50% of mineral fertilizers with pig [...] Read more.
Optimizing organic fertilizer substitution is essential for enhancing the sustainability of agriculture and achieving a balance between crop productivity, nutritional quality, and environmental safety. Here, we conducted an 11-year field experiment to evaluate the effects of substituting 50% of mineral fertilizers with pig manure (PM) or cattle manure (CM) on the nutritional quality of wheat grain, heavy metal (HM) accumulation, and associated human health risks. The yield and protein content were highest in the mineral fertilizer (MF) treatment, and grain micronutrients (Fe, Mn, Cu, Zn) were 6.7–13.8% higher under organic substitution (PM/CM) than in the MF treatment. The Ni, Pb, and As contents were 35.4–43.0% higher in the PM treatment than in the MF treatment, which stems from the higher HM content in pig manure. Health risk assessments indicated that the Hazard Index (HI) for children exceeded 1 in the PM treatment, primarily due to As, which accounted for 69.6% of the HI. All treatments remained within safe thresholds, although As and Pb posed detectable carcinogenic health risks. The higher levels of Ni and As in pig manure likewise led to a significant increase in the health risk associated with the PM treatment compared to the MF treatment. We developed a novel Grain Quality Index (GQI) that combined nutrient and HM data, which indicated that the nutritional quality of wheat grain was similar in the CM and MF treatments. The GQI was 9.1% lower in the PM treatment than in the MF treatment. These findings suggest that the substitution of mineral fertilizer with cow manure can help achieve a balance between yield, nutrition, and safety, and more stringent regulation of HMs is required for the use of pig manure. Our findings provide actionable insights with implications for sustainable wheat production policies. Full article
(This article belongs to the Special Issue Nutrient Enrichment and Crop Quality in Sustainable Agriculture)
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15 pages, 702 KB  
Review
The Role of Nutritional Therapy in the Treatment of Adults with Crohn’s Disease: A Review
by Raffaele Li Voti, Fabio Salvatore Macaluso, Elena Banci, Angelo Campanozzi, Giulia D’Arcangelo, Alessia De Blasi, Salvatore Oliva, Elena Sofia Pieri, Sara Renzo, Cosimo Ruggiero, Giusy Russo, Luca Scarallo, Paolo Lionetti and Ambrogio Orlando
Nutrients 2025, 17(20), 3186; https://doi.org/10.3390/nu17203186 - 10 Oct 2025
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Abstract
Crohn’s disease (CD) is an immune-mediated inflammatory bowel disease (IBD) with a multifactorial pathogenesis involving genetic predisposition, immune dysregulation, and environmental triggers. Dietary patterns have recently garnered growing attention for their potential benefits and risks in patients with IBD. Nutritional therapy has been [...] Read more.
Crohn’s disease (CD) is an immune-mediated inflammatory bowel disease (IBD) with a multifactorial pathogenesis involving genetic predisposition, immune dysregulation, and environmental triggers. Dietary patterns have recently garnered growing attention for their potential benefits and risks in patients with IBD. Nutritional therapy has been established as an effective option in pediatric populations, but its role in adults remains less defined. The available studies indicate that while no single diet can be universally recommended, adherence to a Mediterranean diet is associated with multiple health benefits. Nutritional therapy appears promising in inducing clinical remission in adults with mild to moderate CD, particularly when partial enteral nutrition is combined with food-based modifications. Tailoring these strategies to cultural contexts and providing support from qualified dietitians may improve adherence, clinical outcomes, and overall quality of life. This review highlights the growing role of nutritional therapy in adult CD and its potential integration into routine management alongside conventional treatments. Full article
(This article belongs to the Section Nutritional Immunology)
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33 pages, 3111 KB  
Review
Nutrition and Uterine Fibroids: Clinical Impact and Emerging Therapeutic Perspectives
by Francesco G. Martire, Eugenia Costantini, Ilaria Ianes, Claudia d’Abate, Maria De Bonis, Giovanni Capria, Emilio Piccione and Angela Andreoli
J. Clin. Med. 2025, 14(20), 7140; https://doi.org/10.3390/jcm14207140 - 10 Oct 2025
Viewed by 30
Abstract
Nutritional factors play a crucial role in many gynecological disorders, particularly those influenced by estrogen. Uterine fibroids are benign tumors that affect a large proportion of women of reproductive age, especially between 30 and 40 years. These lesions may cause significant symptoms, including [...] Read more.
Nutritional factors play a crucial role in many gynecological disorders, particularly those influenced by estrogen. Uterine fibroids are benign tumors that affect a large proportion of women of reproductive age, especially between 30 and 40 years. These lesions may cause significant symptoms, including pelvic pain, heavy menstrual bleeding, and infertility. In younger women, the onset of fibroids is often associated with familial and genetic predisposition, whereas in adulthood, hormonal influences linked to environmental factors and states of exogenous or endogenous hyperestrogenism are more frequently observed. In both contexts, supportive management through an appropriate diet may provide clinical benefit. Although the precise pathogenesis remains incompletely understood, hormonal, genetic, and environmental components—particularly hyperestrogenism—are considered key contributors to fibroid development. Current evidence suggests that consumption of saturated fats, particularly from red meat and full-fat dairy, may raise circulating estrogen concentrations and contribute to the development of fibroids. In contrast, diets abundant in fiber, fruits, and vegetables appear to exert a protective effect, potentially lowering fibroid risk. Obesity, through increased aromatization and consequent estrogen production, also represents an established risk factor. This narrative review aims to explore the role of nutritional determinants in the onset and progression of uterine fibroids, with a specific focus on the impact of individual nutrients, foods, and dietary patterns on clinical outcomes. Particular emphasis is placed on obesity and macronutrient composition (e.g., high-fat versus high-fiber dietary regimens) as potential modulators of circulating estrogen levels and, consequently, fibroid growth dynamics. Furthermore, the potential of nutritional strategies as complementary therapeutic approaches, capable of integrating established clinical practices, is examined. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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14 pages, 659 KB  
Article
CGM-Based Glycemic Metrics Support Estimating Nutritional Risk After Total Pancreatectomy: An Exploratory Retrospective Study
by Ryoma Nakamura, Miyuki Yanagimachi, Kento Mitsuhashi, Masato Yamaichi, Wataru Onodera, Atsufumi Matsumoto, Eri Sato, Yusuke Tando and Yukihiro Fujita
J. Clin. Med. 2025, 14(19), 7124; https://doi.org/10.3390/jcm14197124 - 9 Oct 2025
Viewed by 107
Abstract
Introduction: After total pancreatectomy, patients inevitably develop pancreatogenic diabetes with marked glycemic variability and high risk of malnutrition due to both endocrine and exocrine insufficiency. Weight loss and malnutrition can occur even in those with adequate dietary intake and plausible pancreatic enzyme replacement. [...] Read more.
Introduction: After total pancreatectomy, patients inevitably develop pancreatogenic diabetes with marked glycemic variability and high risk of malnutrition due to both endocrine and exocrine insufficiency. Weight loss and malnutrition can occur even in those with adequate dietary intake and plausible pancreatic enzyme replacement. We hypothesized that glycemic variability is associated with nutritional decline. Methods: We retrospectively analyzed 14 patients who underwent continuous glucose monitoring (CGM) after total pancreatectomy. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI), and patients were classified into malnutrition-risk progression or nutrition-maintaining groups. Then, we evaluated glycemic indices, dietary intake, anthropometry, and pancreatic enzyme replacement therapy (PERT). Results: Insulin use, PERT dose, and dietary intake were approximately comparable between groups. In contrast, the malnutrition-risk progression group showed significantly higher mean glucose and time above range, and lower time in range (TIR). Importantly, TIR consistently showed an inverse association with malnutrition-risk progression across models adjusted for clinical covariates, including time since pancreatectomy, primary diagnosis, insulin regimen, and pancrelipase dose. These findings indicate that the observed relationship between lower TIR and worsening GNRI was independent of dietary intake and adequacy of enzyme replacement therapy, underscoring TIR as a clinically meaningful indicator of nutritional decline in this population. Conclusions: Hyperglycemia and reduced TIR were significantly associated with worsening GNRI after total pancreatectomy, independent of dietary intake or PERT. CGM-based glycemic metrics may help identify patients at risk of malnutrition and guide postoperative management. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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12 pages, 457 KB  
Article
Impaired Kidney Function, Subclinical Myocardial Injury, and Their Joint Associations with Cardiovascular Mortality in the General Population
by Ahmed E. Shatta, Mohamed A. Mostafa, Mohamed A. Attia, Tarek Ahmad Zaho, Richard Kazibwe and Elsayed Z. Soliman
J. Clin. Med. 2025, 14(19), 7123; https://doi.org/10.3390/jcm14197123 - 9 Oct 2025
Viewed by 158
Abstract
Background: The combined impact of impaired kidney function and subclinical myocardial injury (SCMI) on cardiovascular (CV) mortality has not been well studied. We aimed to evaluate their individual and joint associations with cardiovascular mortality. Methods: We analyzed data from 6057 participants (mean age [...] Read more.
Background: The combined impact of impaired kidney function and subclinical myocardial injury (SCMI) on cardiovascular (CV) mortality has not been well studied. We aimed to evaluate their individual and joint associations with cardiovascular mortality. Methods: We analyzed data from 6057 participants (mean age 57.0 ± 13.0 years) in the U.S. Third National Health and Nutrition Examination Survey. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation. Electrocardiographic SCMI was defined as a cardiac infarction/injury score ≥ 10. CV mortality was determined from the National Death Index. Multivariable logistic regression assessed baseline cross-sectional associations between eGFR and SCMI. Cox proportional hazards models were used to examine the individual and combined associations of eGFR and SCMI with CV mortality. Results: At baseline, 1297 participants (21.4%) had SCMI. In multivariable logistic regression analysis, eGFR < 45 mL/min/1.73 m2 (vs. ≥45) was not associated with SCMI (OR [95% CI]: 1.10 [0.84–1.45]). Over a median follow-up of 18.4 years, 690 CV deaths occurred. In separate Cox models, both SCMI (vs. no SCMI) and eGFR < 45 (vs. ≥45) were associated with increased CV mortality risk (HR [95% CI]: 1.36 [1.16–1.60] and 1.56 [1.24–1.99], respectively). Compared with participants with eGFR ≥ 45 and no SCMI, those with both eGFR < 45 and SCMI had the highest CV mortality risk (HR [95% CI]: 2.36 [1.65–3.36]), followed by eGFR < 45 alone (1.47 [1.09–1.96]) and SCMI alone (1.33 [1.11–1.58]). Conclusions: Both reduced eGFR and SCMI were independently associated with CV mortality. Their coexistence showed the highest risk, but without statistical significance compared with each alone, possibly reflecting limited power and distinct mechanisms. Full article
(This article belongs to the Section Cardiovascular Medicine)
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14 pages, 605 KB  
Article
Association Between Adiposity Rebound and the Frequency of Balanced Meals Among Japanese Preschool Children: A Cross-Sectional Study
by Yuki Tada, Kemal Sasaki, Tomomi Kobayashi, Yasuyo Wada, Daisuke Fujita and Tetsuji Yokoyama
Nutrients 2025, 17(19), 3183; https://doi.org/10.3390/nu17193183 - 9 Oct 2025
Viewed by 121
Abstract
Background: The Healthy Japan 21-Phase III dietary recommendations comprise a staple food, main dish, and side dish to maintain nutritional balance and support healthy child growth. The relationship between the frequency of such balanced meals and early adiposity rebound (AR), a predictor of [...] Read more.
Background: The Healthy Japan 21-Phase III dietary recommendations comprise a staple food, main dish, and side dish to maintain nutritional balance and support healthy child growth. The relationship between the frequency of such balanced meals and early adiposity rebound (AR), a predictor of obesity, remains unclear. Objective: This study aimed to examine the association between the frequency of balanced meals (staple food, main dish, and side dish) and early AR in preschool children. Methods: In this cross-sectional secondary analysis of nationwide online survey data of 688 mothers of children aged 3–6 years, dietary habits were assessed using a validated NutriSTEP-based 22-item Japanese Nutrition Screening Questionnaire. AR constituted a body mass index (BMI) increase from the 18- to 36-month health checkups recorded in the Maternal and Child Health Handbook. Risk scores reflecting lower frequency of balanced meals were calculated for staple foods, main dishes, and side dishes. Logistic regression evaluated associations between dietary risk scores and AR, adjusting for the child’s sex, age, gestational age, birth weight, daycare attendance, and parental obesity. Results: Among 688 children, 193 (28.1%) exhibited early AR and had significantly higher BMI at age 3 and the most recent measurement (both p < 0.01). A higher total dietary risk score was independently associated with AR (adjusted odds ratio; 2.58 [95% CI: 1.08–6.16]). In addition, the absolute risk difference between high- and low-risk groups was 8.5% (95% CI: 1.7–15.2%). Conclusions: A lower frequency of balanced meals is associated with early AR. These findings suggest that a simple, meal-balance screening tool could potentially aid in the early identification of the risk of later obesity and timely nutritional guidance. Full article
19 pages, 969 KB  
Article
The Prognostic Role of Geriatric Nutritional Risk Index in Periampullary Cancer Patients Undergoing Pancreaticoduodenectomy: A Propensity Score-Matched Survival Study
by Chih-Ying Li, Wei-Feng Li, Yueh-Wei Liu, Yu-Yin Liu, Cheng-Hsi Yeh, Yu-Hung Lin, Jen-Yu Cheng and Shih-Min Yin
Cancers 2025, 17(19), 3273; https://doi.org/10.3390/cancers17193273 - 9 Oct 2025
Viewed by 69
Abstract
Background: The Geriatric Nutritional Risk Index (GNRI) is a simple tool for nutritional assessment, but its long-term prognostic value in patients undergoing pancreaticoduodenectomy (PD) remains unclear. Methods: This retrospective study included adult patients who underwent PD between January 2014 and December 2023 [...] Read more.
Background: The Geriatric Nutritional Risk Index (GNRI) is a simple tool for nutritional assessment, but its long-term prognostic value in patients undergoing pancreaticoduodenectomy (PD) remains unclear. Methods: This retrospective study included adult patients who underwent PD between January 2014 and December 2023 at Chang Gung Memorial Hospital. Patients were grouped by GNRI: inferior (<82), moderate (82–98), and superior (≥98). Propensity score matching was performed based on age, sex, cancer type, surgical approach, and ASA status. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Results: Among 371 patients, inferior GNRI was associated with worse median survival time (18.64 vs. 34.62 months, HR = 2.953, p < 0.001). This association was observed in both pancreatic cancer and other periampullary malignancies. Inferior GNRI also correlated with higher short-term mortality and adverse perioperative outcomes, including longer ICU stay, and greater need for ventilator support, reintubation, reoperation and total parenteral nutrition (TPN). Conclusions: Preoperative GNRI is a strong predictor of survival and short-term outcomes in PD patients. Early nutritional assessment may aid risk stratification and intervention. Full article
(This article belongs to the Section Methods and Technologies Development)
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17 pages, 772 KB  
Systematic Review
Effectiveness of Interventions to Improve Malnutrition Among Older Adults Living with Frailty Who Are Discharged from the Acute Setting: A Systematic Review
by Cerenay Sarier, Siobhan Walsh, Sheila Bowers, Margaret O’Connor, Ahmed Mohamed, Heather Keller, Katherine L. Ford, Rose Galvin and Anne Griffin
Nutrients 2025, 17(19), 3181; https://doi.org/10.3390/nu17193181 - 9 Oct 2025
Viewed by 265
Abstract
Background & Aim: Malnutrition and frailty are prevalent among older adults following discharge from acute care, including emergency departments. This transition period presents a critical window for targeted nutrition interventions. This systematic review synthesises evidence on the effectiveness of nutrition interventions for malnourished, [...] Read more.
Background & Aim: Malnutrition and frailty are prevalent among older adults following discharge from acute care, including emergency departments. This transition period presents a critical window for targeted nutrition interventions. This systematic review synthesises evidence on the effectiveness of nutrition interventions for malnourished, frail older adults and incorporates analyses of stakeholders’ perspectives, including those of patients, caregivers, and healthcare professionals. By integrating clinical outcomes with stakeholder experiences, the review aims to identify strategies that can optimise nutritional care and support recovery in the post-acute setting. Methods: Searches were conducted in Scopus, CINAHL, EBSCO, EMBASE, and PubMed for randomised controlled trials (RCTs) of nutrition interventions in participants ≥65 years living with frailty and identified as malnourished on discharge from acute care. The primary outcome was assessing the effects of nutrition interventions on malnutrition, nutrition status, physical function and frailty, food intake, and quality of life. Secondary outcomes were hospital readmission and mortality. The quality of studies was assessed using the Cochrane Risk of Bias Tool (V2). Results: Five RCTs with 551 participants were included. Nutrition interventions, including counselling, oral nutrition supplements, and multidisciplinary strategies, improved dietary intake, weight, frailty, physical function, BMI, and quality of life in older adults post-discharge. Some studies also reported reduced hospital stays, readmissions, and mortality. However, none explored stakeholder perspectives, highlighting a gap in person-centred transitional care design. Conclusion: This systematic review highlights a critical gap in evidence for nutrition interventions targeting frail older adults at hospital discharge. While short-term benefits were observed, long-term sustainability and real-world feasibility remain uncertain. The absence of stakeholder involvement further limits person-centred design. These findings underscore the need for integrated nutrition care pathways that embed effective interventions into transitional care models. Full article
(This article belongs to the Section Geriatric Nutrition)
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16 pages, 2018 KB  
Article
Nutritional Adequacy and Day-to-Day Energy Variability: Impacts on Outcomes in Severe Trauma Patients
by Jovana Stanisavljevic, Nikola N. Grubor, Sergej Marjanovic, Ivan Palibrk, Mihailo Bezmarevic, Jelena Velickovic, Adi Hadzibegovic, Marija Milenkovic, Sanja Ratkovic and Bojan Jovanovic
Nutrients 2025, 17(19), 3180; https://doi.org/10.3390/nu17193180 - 9 Oct 2025
Viewed by 301
Abstract
Background: Optimal energy and protein delivery during the early phase of severe trauma remains unclear. Observational studies frequently contradict the findings of randomized controlled trials, raising concerns about confounding factors. The aim of this study is to assess nutritional adequacy and daily variability [...] Read more.
Background: Optimal energy and protein delivery during the early phase of severe trauma remains unclear. Observational studies frequently contradict the findings of randomized controlled trials, raising concerns about confounding factors. The aim of this study is to assess nutritional adequacy and daily variability in the energy gaps and its impact on outcomes using innovative statistical methods. Methods: Prospective observational study enrolled severely injured patients in the ICU at the Level 1 trauma center between October 2023 to April 2025. To describe the evolution of calorie and protein deficits during the first 10-day ICU stay, we utilized a linear mixed-effects model to estimate each patient’s individual energy gap trajectory. Results: 286 patients were analyzed. Median APACHE II and ISS score was 16.0 (12.0–20.0) and 22.0 (18.0–27.0), respectively. Mortality rate was 35.3%. Patients received 68.3% of prescribed calories and 76.8% of proteins. Admission energy deficit, rate of caloric intake, and their interaction are associated with ICU mortality. Increased day-to-day energy variability was associated with longer duration of mechanical ventilation (HR = 0.55, 95% CI: 0.31–0.99; p = 0.047). Patients who achieved better caloric (HR = 0.68, 95% CI: 0.48–0.98, p = 0.036) and protein (HR = 0.29, 95% CI: 0.09–0.96, p = 0.043) nutrition had a lower hazard of developing nosocomial infection. Conclusions: This study supports the 2023 ESPEN guidelines, showing that achieving the recommended energy and protein intake during the early phase of severe trauma is linked to lower mortality rates, shorter mechanical ventilation time, and reduced risk of nosocomial infections. Full article
(This article belongs to the Section Clinical Nutrition)
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17 pages, 587 KB  
Review
Dietary Habits and Their Impact on Pediatric Obesity and Asthma: A Narrative Review with Emphasis on the Mediterranean Diet
by Marianna Deligeorgopoulou, Sophia Tsabouri, Ekaterini Siomou, Antonios P. Vlahos and Anastasios Serbis
Children 2025, 12(10), 1354; https://doi.org/10.3390/children12101354 - 9 Oct 2025
Viewed by 136
Abstract
Obesity and asthma are increasingly prevalent chronic conditions that often coexist in the pediatric population and may influence each other through shared pathophysiological mechanisms. Obesity can affect asthma expression and severity via mechanical effects on the lungs, systemic inflammation, altered adipokine levels, and [...] Read more.
Obesity and asthma are increasingly prevalent chronic conditions that often coexist in the pediatric population and may influence each other through shared pathophysiological mechanisms. Obesity can affect asthma expression and severity via mechanical effects on the lungs, systemic inflammation, altered adipokine levels, and metabolic dysregulation. These mechanisms contribute to a distinct asthma phenotype in children with obesity that is often less responsive to standard therapy. Nutrition plays a critical role in this context by influencing immune function, inflammation, and respiratory outcomes. Specific dietary patterns, such as the Mediterranean diet, along with nutrients including vitamin D, antioxidants, and polyunsaturated fatty acids, have been associated with the modulation of airway inflammation and asthma risk. Additionally, early-life nutritional exposures and gut microbiota composition may influence immune development and the propensity for allergic diseases. This narrative review aims to synthesize current evidence on the interplay between obesity, asthma, and nutrition in the pediatric population, highlighting potential dietary interventions and targets for improved asthma management in children with obesity. Full article
(This article belongs to the Section Global Pediatric Health)
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27 pages, 1751 KB  
Systematic Review
Therapeutic Efficacy of Soy-Derived Bioactives: A Systematic Review of Nutritional Potency, Bioactive Therapeutics, and Clinical Biomarker Modulation
by Zara Fatima, Nizwa Itrat, Beenish Israr and Abdul Momin Rizwan Ahmad
Foods 2025, 14(19), 3447; https://doi.org/10.3390/foods14193447 - 9 Oct 2025
Viewed by 291
Abstract
Soybeans (Glycine max) are nutrient-dense legumes and a high-quality plant-based protein source containing all essential amino acids. With a protein content of 36–40%, soy surpasses many other plant-derived proteins in nutritional value. Its bioactive components, particularly peptides and isoflavones, contribute to [...] Read more.
Soybeans (Glycine max) are nutrient-dense legumes and a high-quality plant-based protein source containing all essential amino acids. With a protein content of 36–40%, soy surpasses many other plant-derived proteins in nutritional value. Its bioactive components, particularly peptides and isoflavones, contribute to reducing inflammation, oxidative stress, and the risk of chronic diseases. In undernourished regions such as Pakistan, where protein-energy malnutrition is prevalent among women and children, soy offers a sustainable and cost-effective nutritional intervention. This review synthesizes findings from biochemical analyses, nutritional profiling, and clinical trials evaluating the impact of soybean protein and its bioactive compounds on growth, metabolic health, immune function, and disease prevention. Emphasis was placed on studies relevant to food-insecure populations and technological innovations enhancing soy product bioavailability. Soy protein has been shown to have positive effects on hormonal regulation, cardiovascular health, cognitive function, and immune support. Technological approaches such as fortification and fermentation improve nutritional bioavailability and sensory acceptance. The integration of soy into local diets enhanced nutritional adequacy, promoted environmental sustainability, and aligned with Sustainable Development Goals. Soybeans represent a sustainable, nutrient-rich solution to combat protein-energy malnutrition in vulnerable communities. Their high-quality protein profile, therapeutic properties, and adaptability to local food systems make them an effective strategy for improving public health and supporting environmental resilience. Full article
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