Search Results (398)

Background/Objectives: Dysphagia represents a significant global health concern with particularly high prevalence in specific clinical conditions, yet educational gaps persist among healthcare professionals and caregivers. This observational, cross-sectional quantitative study aimed to provide a comprehensive overview of the current self-perceived knowledge and learning needs among stakeholders involved in dysphagia management. Methods: An international online survey was conducted in five European countries (Greece, Italy, Lithuania, Spain, and Turkey) with 463 participants: 297 professionals (healthcare and non-health specialists, educators, students) and 166 non-professionals (patients, family members, caregivers, interested individuals). Two structured questionnaires explored self-perceived knowledge, learning needs, relevancy of thematic areas, and preferred learning methods. Chi-square and Fisher’s exact tests were used for statistical comparisons. Results: Professionals reported higher self-perceived knowledge than non-professionals (p < 0.001), yet both groups expressed comparable needs for further education. Priority learning areas varied by respondent profile: “Identification & Treatment” was prioritized by both speech-language pathologists and healthcare specialists, as well as by non-professionals, while dietitian-nutritionists focused on “Diet & Nutrition” and “Food Preparation”. Short-duration courses and visual, hands-on learning tools were preferred across groups. Conclusions: This study highlights a broad demand for dysphagia education among professionals and non-professionals. Tailored, technology-enhanced learning programs could bridge existing knowledge gaps, strengthen multidisciplinary collaboration, and support better daily management of dysphagia. Full article

Nutrition knowledge is essential for optimizing performance, recovery, and overall health in athletes. This study aimed to (1) adapt and validate the Hungarian version of the ANSKQ (Trakman et al., 2017) (ANSKQ-HU) and (2) assess the nutrition knowledge of Hungarian elite and recreational athletes. Following standard translation procedures and expert review, face validity was established. Data were collected from 1.335 athletes, and item difficulty, exploratory factor analysis (EFA), and reliability analyses were performed. A three-factor structure emerged: (1) Fundamentals of nutrition, energy needs, and prohibited substances; (2) Micronutrients and performance-enhancing sports nutrition; and (3) Utilization of macronutrients. While Cronbach’s alpha values were low (α = 0.41–0.62), this seemed acceptable given the dichotomous nature of the questionnaire. Most participants scored poorly (63.3%), with the lowest results in the micronutrients and performance-enhancing nutrition factor. Only 6.9% had formal nutrition education and most frequently respondents received help from coaches, family members, and friends. These findings highlight a significant gap in sports nutrition knowledge among Hungarian athletes and support the need for educative activities organized by sport nutrition professionals. The ANSKQ-HU is a reliable and valid tool for assessing nutrition knowledge in Hungarian athletes and can be a useful questionnaire for their support team (nutritionists, physicians). Full article

Background: Adolescence represents a critical period for growth and athletic development, yet young athletes frequently demonstrate significant gaps in nutritional knowledge that can impair performance and long-term health outcomes. Limited research exists on comprehensive nutrition education interventions for adolescent soccer players in North African populations. Objective: To evaluate both general and sports-specific nutritional knowledge among adolescent soccer players from an elite Tunisian club and assess the feasibility of a digital nutrition intervention using mobile application technology. Methods: A cross-sectional survey was conducted between June and August 2024 among 50 male soccer players aged 11–18 years from Étoile du Sahel club in Sousse, Tunisia. Data were collected via a structured questionnaire comprising sections on basic nutrition knowledge, influences on food choices, sports nutrition knowledge and practices, and demographic information. A pilot digital intervention using the FatSecret app was implemented with 8 participants over 4 weeks, involving meal photo uploads and nutritionist feedback. Results: Participants had a mean age of 15.16 ± 1.55 years, with 92% reporting no formal nutrition education. While 90% correctly identified carbohydrates as the primary energy source, only 2% recognized that fat provides the highest energy density. Significant misconceptions existed regarding sports nutrition: 74% incorrectly believed that consuming protein 2–4 h before an event enhances performance, and only 17% knew the recommended pre-event carbohydrate intake. Food choices were primarily influenced by cravings (80%) and sensory appeal rather than health considerations (20%). The digital intervention demonstrated extremely low engagement, with minimal participation in meal photo uploads. Conclusions: This study reveals critical gaps in both general and sports-specific nutritional knowledge among adolescent soccer players in Tunisia, providing important descriptive information about knowledge distribution in this population. While knowledge deficits are substantial, it is important to acknowledge that this cross-sectional assessment documents only knowledge patterns, without measures of actual dietary intake or athletic performance. The persistent misconceptions and the low feasibility of the digital intervention provide important lessons regarding technology-based approaches to nutrition education in this age group, highlighting challenges in sustained engagement that must be addressed in future intervention design. Full article

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

Aims: Gestational diabetes mellitus (GDM) represents an increasing global challenge. Mediterranean diet interventions have proven benefits, but their implementation is limited by the absence of nutritionists in many public health systems. This study aimed to evaluate whether a video intervention guided by a nutritionist could increase compliance to Mediterranean diet and reduce the incidence of GDM and adverse maternal–neonatal outcomes. Methods: In this randomized controlled trial, 1750 consecutive pregnant women were allocated (1:1) to standard care (verbal, printed advice) or to a video designed by a nutritionist promoting a Mediterranean and physical activity. The primary outcome was the incidence of GDM; secondary outcomes included other pregnancy-related complications. Dietary adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS) score. Results: The experimental group increased their MEDAS score from baseline to GDM screening (mean difference (95% CI) 0.41 (0.23; 0.60); p < 0.001), mainly through greater extra virgin olive oil and nut intake and lower consumption of juices and confectionery. GDM incidence declined from 25.1% to 20.7% (p = 0.025), with significant reductions in gestational hypertension, episiotomy and neonatal intensive care unit admissions. Conclusions: Nutritionist-guided video intervention improves adherence to Mediterranean diet and reduces GDM incidence and adverse outcomes. This low-cost, scalable approach may help overcome structural limitations in public health systems. Full article

Background/Objectives: Transportation is a critical social determinant of health with direct impacts on healthcare access and utilization. This study examines transportation challenges faced by low-income individuals with chronic conditions who participated in the Food as Medicine (FAM) program offered by their primary care provider and explores the strategies they employ to overcome those challenges, particularly during the COVID-19 pandemic. Methods: We conducted semi-structured interviews with 36 FAM participants from Grady Health System in Atlanta, Georgia between May 2022 and October 2023. Interviews explored their ability to access routine care, FAM, and healthy food as prescribed by their physicians and nutritionists, as well as how the COVID-19 pandemic affected their transportation challenges and solutions. Results: Participants reported various transportation barriers including long wait times, delays, cost burdens, unreliable services, and coordination failures, which contributed to missing doctor appointments and FAM attendance. To overcome those challenges, participants planned trips in advance, used multiple transportation options, relied on social networks, or reduced and sometimes forwent trips. The COVID-19 pandemic limited their accessibility to healthcare, FAM, and healthy food options by reducing business hours and disrupting transportation services. Alternatives such as telemedicine and online ordering were less utilized due to distrust, dissatisfaction, and limited digital literacy. Conclusions: Transportation barriers can substantially restrict healthcare and food access for low-income individuals managing chronic conditions, especially during public crises that may lead to service disruptions. Transportation assistance that accommodates individuals’ financial circumstances and health conditions, implemented through collaborative efforts of healthcare institutions, transportation agencies, and governments, is essential to facilitating chronic disease management and reducing health disparities. Full article

Background: Social media has emerged as a powerful communication tool for healthcare professionals, including nutritionists and dietitians, particularly since the COVID-19 pandemic. Evidence suggests that their online presence can enhance nutritional literacy and play a crucial role in countering misinformation. Objective: This systematic review aims to investigate how and why Registered Nutritionists and Dietitians (RNDs) use social media in their professional practice, focusing on benefits, challenges, and impact. Methods: A systematic literature search was conducted between 1 January 2019 and 28 February 2024, in PubMed, Scopus, Scholar, and SciELO databases using terms such as ‘nutritionist’, ‘dietitian’, and ‘social media’. Quality was assessed using the MMAT tool. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The included studies were analysed with respect to their content, professional practices, and patterns of social media use. Results: Of the 359 articles identified through the systematic search, 10 cross-sectional studies conducted using questionnaires were included in this review. Sample sizes ranged from 10 to 2542 participants across nine countries. Instagram and Twitter were the most frequently used platforms among RDNs, primarily for sharing evidence-based nutritional information, counselling content, and professional promotion. Reported usage ranged from 37.5% to 100%, with a marked increase during the COVID-19 pandemic, especially among younger professionals. Key enablers included enhanced communication, professional visibility, and cost-effective outreach, while main challenges involved limited digital literacy and difficulties replicating face-to-face counselling online. Although ethical concerns were reported, many RNDs maintained compliance with professional standards, particularly in regions with strict marketing regulations. Conclusions: This systematic review provides evidence that social media is a valuable tool for RNDs, particularly in the context of food and/or nutritional education. RNDs would benefit from training in content creation, knowledge dissemination and ethical digital communication. However, clearer guidelines from professional organisations are also recommended. Full article

Background: The increase in obesity rates and related liver diseases has risen in recent years in Mexico. Dietary factors, such as the imbalance between n-6 and n-3 polyunsaturated fatty acids, have been associated with a higher risk of developing conditions such as fatty liver. The objective of this study was to analyse the influence of the dietary n-6/n-3 ratio on fatty liver in Mexican adults. Methods: This analytical cross-sectional study included 213 Mexican adults aged 18 to 65 years, of both genders. The dietary n-6/n-3 ratio was calculated using the Nutritionist Pro software. Participants were divided into two groups according to the median of their dietary n-6/n-3 intake ratio: “low” (<10.2:1) and “high” (≥10.2:1). Anthropometric and biochemical markers were evaluated using standardised methods. The hepatic steatosis index (HSI) was used as a surrogate marker of fatty liver. Multivariate logistic regression analyses were conducted to predict fatty liver based on HSI. Results: Overall, the mean dietary n-6/n-3 ratio was 12.75 in the general population. Higher HSI values were found in participants with a high n-6/n-3 ratio (p = 0.038). In the multivariate model, the n-6/n-3 ratio was positively associated with high HSI (OR = 1.48, 95% CI, 1.02, 1.99). Conclusions: This study concludes that a high n-6/n-3 ratio may contribute to the development of fatty liver in Mexican adults. These results highlight the importance of a balanced intake of fatty acids to prevent metabolic complications and improve public health. Full article

Background: Bioelectrical Impedance Vector Analysis (BIVA) is a qualitative method that standardizes resistance and reactance relative to stature (R/H and Xc/H) and plots them as vectors on an R-Xc graph. This equation-free approach assesses body composition, allowing for the evaluation of hydration status and cellular integrity through tolerance ellipses. This study aimed to systematically map BIVA reference ellipses across general, pediatric, pathological, and athletic populations. Methods: A scoping review was conducted according to PRISMA-ScR guidelines. Five databases were searched. Extracted data included (a) sample characteristics (sample size, age, sex, BMI, country, ethnicity), (b) population type, (c) analyzer specifications, and (d) R/H and Xc/H means, standard deviations, and correlation values. Results: A total of 53 studies published between 1994 and July 2025 were included. From these, 508 tolerance ellipses were identified: 281 for the general population (18–92 years), 133 for children/adolescents (0–18 years), 49 for athletes, and 45 for pathological groups. Studies were primarily conducted in Europe and the Americas, using 11 analyzers with variations in measurement protocols, including body side, posture, and electrode placement. Conclusions: This scoping review categorizes the existing BIVA tolerance ellipses by population type, sex, age, BMI, device used, and measurement protocol. The structured presentation is intended to guide researchers, clinicians, nutritionists, and sports professionals in selecting appropriate reference ellipses tailored to specific populations and contexts. Full article

Purpose: The aim of this review is to provide an overview of the effects of commonly used dietary supplements on soccer performance and to bridge the gap between scientific evidence and their practical application by practitioners working with elite soccer players. Methods: Relevant literature involving dietary supplement use in soccer players was identified through searches of PubMed, EMBASE, Scopus, and Web of Science. Additionally, insights were gathered from a cross-sectional online questionnaire completed by practitioners (nutritionists, physicians, sport scientists, strength and conditioning coaches, and heads of performance) working with first-division men’s teams across five European leagues. Eligible respondents were over 18 years old with >2 years of experience in elite sport. The 20-question survey, designed on Qualtrics and pilot-tested for content validity, covered practitioner background, beliefs about supplementation, and real-world practices. The study was approved by the Ethical Independent Committee in Genoa, Italy (Ref. 2020/12). Results: Among performance-enhancing supplements, caffeine has been shown to improve endurance, sprint performance, power, and cognitive function, while creatine consistently enhances short-duration, high-intensity efforts. Beta-alanine and sodium bicarbonate help reduce the buildup of acidity in muscles during repeated high-intensity exercise, supporting repeated sprint performance. For hydration and endurance support, dietary nitrates improve blood flow and oxygen delivery to muscles, and glycerol enhances fluid retention in hot environments and during compressed match schedules, where players compete in multiple matches within a short recovery window. Regarding recovery aids, protein and tart cherry supplementation have been shown to accelerate recovery, reduce muscle damage, and support training adaptations. Field insights revealed that creatine and caffeine were widely adopted by practitioners (>90%), with protein powders also commonly recommended (>80%). In contrast, beta-alanine, tart cherry, and dietary nitrates were only partially integrated into daily practice (30%, 32%, and 48.5%, respectively), while sodium bicarbonate (24%) and glycerol (10.5%) were used by a minority. Conclusions: Although scientific evidence provides a strong foundation for the efficacy of dietary supplements, their translation into elite soccer practice is shaped by a range of practical factors, including cultural resistance, taste preferences, gastrointestinal side effects, established team routines, and individual player preferences. These findings highlight the importance of targeted education for players and staff, individualized supplementation plans, and close collaboration between nutritionists, coaches, and medical teams. However, our survey did not directly assess reasons for non-implementation. In addition to practical barriers reported by practitioners, unfamiliarity with current evidence likely contributes to this evidence–practice gap. Full article

Background/Objectives: The increasing presence of “no added sugar” products in the Polish food market provides consumers and nutritionists with access to products with varying nutritional compositions. Comparing the nutritional and energy values of products with and without added sugar provides objective data on their composition, which is important for informed diet planning and for monitoring differences between product groups. Methods: The research material included a total of 1278 food products, including 744 labeled “without added sugar” and 534 containing added sugar, obtained from four online stores and three offline retail outlets in Poland in the second and third quarters of 2023. The product assessment was based on an analysis of the nutritional and energy value, expressed per 100 g of each product. Results: The quantitative analysis revealed that products with added sugar were characterized by a higher energy value and a statistically significantly higher content of saturated fatty acids, carbohydrates, and sugars. Conclusions: Comparison of selected product groups revealed significant differences in nutritional and energy values. Analyzing these differences provides a practical overview of product composition and can be a useful source of information for consumers and nutritionists. Full article

Background/Objectives: As convenience store meals become a major dietary source for modern society, the reliability of their nutrition labels is increasingly scrutinized. With advances in artificial intelligence (AI), large language models (LLMs) have been explored for automated nutrition estimation. Aim: To evaluate the accuracy and clinical applicability of AI-assessed nutrition data by comparing outputs from five AI models with professional dietitian estimations and labeled nutrition facts. Methods: Eight ready-to-eat convenience store meals were analyzed. Four experienced dietitians independently estimated the meals’ calories, macronutrients, and sodium content based on measured food weights. Five AI chatbots were queried multiple times with identical input prompts to assess intra- and inter-assay variability. All results were compared to the official nutrition labels to quantify discrepancies and cross-model consistency. Results: Dietitian estimations showed strong internal consistency (CV < 15%), except for fat, saturated fat and sodium (CVs up to 33.3 ± 37.6%, 24.5 ± 11.7%, and 40.2 ± 30.3%, respectively). Among AI models, ChatGPT4.o showed relatively consistent calory, protein, fat, saturated fat and carbohydrate estimates (CV < 15%), and Claude3.7, Grok3, Gemini, and Copilot showed caloric and protein content as consistent (CV < 15%). Sodium values were consistently underestimated across all AI models, with CVs ranging from 20% to 70%. The accuracy of nutritional fact estimation over the five AI models for calories, protein, fat, saturated fat and carbohydrates was between 70 and 90%; when compared to the nutritional labels of RTE, the sodium content and saturated fat estimated were severely underestimated. Conclusions: Current AI chat models provide rapid estimates for basic nutrients and can aid public education or preliminary assessment; GPT-4 outperforms peers in calorie and potassium-related estimations but remains suboptimal in micronutrient prediction. Professional dietitian oversight remains essential for safe and personalized dietary planning. Full article

Apple fruit size affects market value, yet its impact on biochemical and sensory traits is poorly understood. This study provides the first comprehensive metabolic profiling of peel and flesh across five cultivars, including red-fleshed ‘Baya Marisa’ and four white-fleshed cultivars (‘Opal’, ‘Red Boskoop’, ‘Crown Prince Rudolf’, and ‘Topaz’), in two size groups: large (>70 mm, Class I) and small (55–70 mm, Class II). Sugars and organic acids varied by cultivar but not consistently by size. White-fleshed small apples had higher flesh phenolics, suggesting a dilution effect, while ‘Baya Marisa’ showed no size-related phenolic differences, indicating potential genetic influence. VOCs were mainly aldehydes, with cultivar-specific differences outweighing size effects. Fruit maturity and controlled-atmosphere storage likely limited ester production. These findings demonstrate that fruit size influences certain biochemical traits in a cultivar-dependent manner. This study’s novelty lies in combining tissue-specific metabolite profiling with size comparisons across multiple cultivars, providing practical insights for breeders, nutritionists, and the fruit industry. This work supports size-specific quality assessment and valorization of smaller apples for fresh consumption and processing, challenging conventional market classifications based solely on size. Full article

Background/Objectives: For runners competing abroad in sports events, the hours before a race are marked by heightened psychological tension, where even food choices can feel crucial to success. While pre-race nutrition is often addressed in terms of physiological needs, little is known about the inner psychological processes that accompany food decisions in unfamiliar cultural and environmental contexts. This study explores the inner dialogues, anxieties, and coping mechanisms of international runners facing the question of whether and what to eat before competition. Methods: A qualitative study was conducted with twelve international participants (from the United Kingdom, Germany, and Ukraine) of the Poznan Half Marathon 2025. Data were collected through semi-structured in-depth interviews. Participants possessed a minimum of two years’ experience competing in international events. Results: Three thematic areas were identified: (1) anticipatory anxiety and fear of making nutritional mistakes before the race, (2) internal negotiation between prior nutritional knowledge and situational trust, and (3) ritualization and individualized norms as fundamental mechanisms of psychological regulation. These themes influenced how runners experienced pre-race nutrition, shaping their emotional states, decision-making processes, and coping strategies in the context of international competition. Conclusions: Pre-race nutrition decisions are deeply embedded in emotional and cognitive landscapes shaped by stress, cultural context, and individual history. Recognizing these inner dynamics can help coaches, sports nutritionists, and event organizers better support the psychological well-being of traveling athletes. Full article

Background: The increasing use of food supplements (FSs) and the knowledge gaps among healthcare professionals (HPs) and non-healthcare professionals (nHPs) in Portugal regarding their influence on dietary patterns and health need investigating. This study aimed to explore FS users’ lifestyle and dietary patterns, identifying differences and how professional background influences these patterns. Methods: A cross-sectional study was conducted among 1122 Portuguese adults aged 35 ± 14.0 yrs (between 18 and 85), via snowball sampling, collecting data on sociodemographic characteristics, dietary patterns, FS use, and health attitudes. Cluster analysis (k-means) revealed four patterns: (1) professional supplement users with a healthy diet (PSHD), (2) professional non-supplement users with a less healthy diet (PnSLHD), (3) non-professional supplement users with a healthy diet (nPSHD), and (4) non-professional non-supplement users with a less healthy diet (nPnSLHD). Logistic regression assessed associations with lifestyle traits. Results: Significant sociodemographic differences existed between HPs and nHPs. Higher nutritional knowledge and nutritionist recommendations were strongly associated with a healthier diet and FS use (PSHD, nPSHD). Smoking was associated with less healthy patterns (PnSLHD, nPnSLHD). Among nHPs, males were significantly more likely to belong to the nPSHD group (OR: 1.61) compared to females (OR: 0.61). Distinct dietary and lifestyle patterns among Portuguese FS users and non-users vary by background. Conclusions: The findings suggest that FS users often maintain healthier lifestyles, indicating that FSs typically supplement rather than compensate for poor habits. Full article