Search Results (271)

Background: Metabolic syndrome, a clinical condition defined by central obesity, impaired glucose regulation, elevated blood pressure, hypertriglyceridemia, and low high-density lipoprotein cholesterol across the lifespan, is now a major public health issue typically managed with lifestyle, behavioral, and dietary recommendations. However, “one-size-fits-all” recommendations often yield modest, heterogeneous responses and poor long-term adherence, creating a clinical need for more targeted and implementable preventive and therapeutic strategies. Objective: To synthesize evidence on how the gut microbiome can inform precision nutrition and exercise approaches for metabolic syndrome prevention and management, and to evaluate readiness for clinical translation. Key findings: The gut microbiome may influence cardiometabolic risk through microbe-derived metabolites and pathways involving short-chain fatty acids, bile acid signaling, gut barrier integrity, and low-grade systemic inflammation. Diet quality (e.g., Mediterranean-style patterns, higher fermentable fiber, or lower ultra-processed food intake) consistently relates to more favorable microbial functions, and intervention studies show that high-fiber/prebiotic strategies can improve glycemic control alongside microbiome shifts. Physical exercise can also modulate microbial diversity and metabolic outputs, although effects are typically subtle and may depend on baseline adiposity and sustained adherence. Emerging “microbiome-informed” personalization, especially algorithms predicting postprandial glycemic responses, has improved short-term glycemic outcomes compared with standard advice in controlled trials. Targeted microbiome-directed approaches (e.g., Akkermansia muciniphila-based supplementation and fecal microbiota transplantation) provide proof-of-concept signals, but durability and scalability remain key limitations. Conclusions: Microbiome-informed personalization is a promising next step beyond generic guidelines, with potential to improve adherence and durable metabolic outcomes. Clinical implementation will require standardized measurement, rigorous external validation on clinically meaningful endpoints, interpretable decision support, and equity-focused evaluation across diverse populations. Full article

Chronic low-grade inflammation, or “inflammaging,” represents a central mechanism linking dietary patterns, gut microbiome composition, and biological aging. Evidence from Blue Zone populations and Mediterranean diet studies demonstrates that specific nutritional interventions are associated with up to 23% lower all-cause mortality, with analyses suggesting that part of this association may be mediated by measurable improvements in inflammatory biomarkers. This paper synthesizes published evidence from Mediterranean diet trials, centenarian microbiome studies, and digital health platforms to propose a comprehensive digital health framework that integrates quarterly inflammation and microbiome monitoring with continuous lifestyle tracking to deliver personalized longevity interventions. This paper introduces the Longevity-Inflammation Index (L-II), a composite score combining high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and microbiome-derived markers, with scoring algorithms derived from centenarian population studies. The proposed platform leverages artificial intelligence to generate evidence-based recommendations adapted from centenarian and Mediterranean dietary patterns. Published evidence from multiple randomized controlled trials demonstrates that Mediterranean dietary interventions reduce hs-CRP by 18–32%, increase microbiome diversity by 6–28%, and improve metabolic markers including HOMA-IR and TG/HDL ratios. Digital health platforms demonstrate sustained engagement rates of 58–84% at 12 months, with dietary logging frequencies of 4–6 days per week. Cost-effectiveness analyses of dietary interventions show incremental cost-effectiveness ratios of USD 2100–4800 per quality-adjusted life year gained. This inflammation-centered digital health framework offers a scalable approach for translating longevity research into practical interventions for healthy aging, with validation studies needed to confirm the integrated platform’s efficacy and real-world implementation feasibility. Full article

Introduction: This document presents recommendations of the Polish Respiratory Society on discharge instructions following hospitalization for an exacerbation of chronic obstructive pulmonary disease (COPD). Methods: The Delphi method was applied to achieve consensus among independent experts. Results: Fourteen recommendations were formulated. Experts emphasized that discharge summaries require clear graphical and editorial design to ensure readability for both patients and healthcare professionals. The involvement of a multidisciplinary team was recommended to provide coherent and comprehensive documentation. Discharge instructions should be discussed with the patient during hospitalization and supplemented with standardized educational materials provided separately. These materials should cover inhaler technique, smoking cessation, physical activity, pulmonary rehabilitation, and vaccination. For patients with respiratory failure, home oxygen therapy or non-invasive ventilation must be addressed. Discharge recommendations should highlight modifications in baseline COPD treatment and management of comorbidities. A personalized action plan for future exacerbations is essential, and dietary consultation is advised. Finally, discharge summaries should specify follow-up appointments and include prescriptions for inhaled medications. Conclusions: The Polish Respiratory Society recommends that discharge instructions be provided to all patients hospitalized for a COPD exacerbation. Full article

Background: Obesity is a multifactorial chronic disease associated with increased risk of metabolic disorders, reduced quality of life, and rising healthcare costs. Although weight reduction is achievable through various dietary approaches, maintaining the achieved results remains a major clinical challenge. This review aims to identify and discuss dietary, behavioral, and lifestyle strategies that support long-term weight loss and weight maintenance. Methods: A narrative literature review was conducted in two stages using PubMed, Scopus, and Google Scholar. The search included peer-reviewed studies published between 2015 and 2025 focusing on individuals with overweight and obesity. Randomized controlled trials, observational studies, systematic and narrative reviews, and meta-analyses discussing short-term and long-term weight loss outcomes and factors influencing the maintenance of reduced body weight were included. Results: Multiple nutritional strategies, including continuous and intermittent energy restriction, very low-calorie diets, and macronutrient modification, can be effective for weight reduction. However, long-term outcomes are primarily dependent on adherence and consistent implementation of recommendations. Behavioral and psychological factors, such as emotional eating, dietary fatigue, and unrealistic expectations, often contribute to weight regain. Social support, personalized dietary strategies, and sustainable lifestyle habits are key determinants of maintaining weight loss. The current evidence base is limited by the scarcity of long-term follow-up studies and high methodological variability across interventions. Conclusions: Long-term weight management requires a comprehensive, individualized approach that integrates dietary strategies with behavioral and lifestyle support. Strengthening adherence and addressing psychological and environmental factors may significantly improve the effectiveness and durability of obesity treatment. Full article

Background: Rising obesity rates among young adults increase long-term health risks, especially cardiometabolic conditions such as type 2 diabetes mellitus. Digital interventions can offer scalable solutions to promote and support healthy behaviors by integrating personalized diet, physical activity promotion, and behavioral support. Objective: To assess the feasibility, user friendliness, adherence, and satisfaction of the Healthy Lifestyle Recommender System (HLRS). Secondary outcomes will include measures of metabolic health and obesity. Methods: A 3-month, single-arm pilot study conducted across European countries, including Bulgaria, Germany, Italy, Netherlands, Portugal, and Spain, enrolling 351 young adults (18–25 years old, BMI 18.5–29.9 kg/m²). The intervention includes a mobile app for meal planning (Nutrida v.1), gamified physical activity encouragement (GameBus), and real-time monitoring via a wearable smartwatch device. Primary outcomes are adherence and engagement, measured through app usage and participant feedback; secondary outcomes include anthropometry, physical activity, dietary patterns, psychological well-being, and selected biomarkers of metabolic health. Expected Outcomes: Improved engagement is expected to enhance lifestyle behaviors, supporting weight management and overall well-being. Findings will guide future large-scale interventions. Conclusions: This study will contribute to minimizing the impact of obesity in Europe. Full article

Background/Objectives: Modern families face challenges in maintaining healthy and sustainable diets due to time constraints and busy lifestyles. The Mediterranean diet (MD), known for its benefits to both personal health and environmental sustainability, is often difficult to apply consistently within households. This paper presents and validates the SWITCHtoHEALTHY AI-based Family Nutrition Recommendation System, designed to generate meal plans aligned with MD guidelines. Methods: Two complementary recommendation engines were developed: the AI-based Family Nutritional Recommender, which creates personalized meal plans for adults that include shared family meals, and the Child Nutritional Recommender, which generates meal plans for children that could also incorporate school menus or proposals from the school cafeteria. Both systems rely on an expert-validated dataset of Mediterranean foods and are designed to comply with the expert-validated nutritional rules based on MD principals and national dietary guidelines. Results: The recommendation systems were validated using data from a real-world family intervention, achieving 90% accuracy in generating meal plans for all family members, while meeting the expert validated dietary rules for both adults and children. Moreover, AI-based Family Nutritional Recommender exceeds 90% accuracy in estimating calorie and nutrient content for adults. Conclusions: The results demonstrate the preliminary potential of AI-based recommendation systems to facilitate healthier and more sustainable dietary habits within modern households by generating personalized, nutritionally balanced family meal plans consistent with MD principles. Full article

Introduction: Nutrition plays a fundamental role in sports performance by influencing energy availability, recovery, and training adaptation. In recent years, different dietary strategies have gained popularity among athletes, although the evidence supporting their efficacy is inconsistent. Objective: This consensus document, developed under the auspices of the Spanish Society of Nutrition, aims to provide a critical overview of the most relevant nutritional strategies currently used in sports and to offer evidence-based practical recommendations for both professional and recreational athletes, coaches, and health professionals. Methods: A narrative review was conducted following standardized scientific procedures by a multidisciplinary panel of experts. The analyzed strategies included high-carbohydrate, low-carbohydrate, ketogenic, intermittent fasting, plant-based, Paleolithic, and carbohydrate periodization diets. Each strategy was assessed based on its physiological rationale, evidence of performance in endurance, strength/power, sprint, aesthetic, weight category, and team sports, practical applications, and potential risks. Results: The available evidence shows that no single dietary strategy can be universally recommended for all athletes. High carbohydrate availability remains the most consistent approach for sustaining performance in endurance and high-intensity efforts. Low-carbohydrate and ketogenic diets enhance fat oxidation but often compromise exercise economy at competitive intensity levels. Intermittent fasting may improve body composition and metabolic health; however, it requires careful adaptation. Well-planned plant-based diets can support performance, although attention to certain nutrients (e.g., B12, iron, and omega-3) is essential. Paleolithic diets improve metabolic parameters but show limited direct evidence of athletic performance. Carbohydrate periodization is a promising tool for combining metabolic adaptations with competitive demands. Conclusions: Nutritional strategies should be individualized according to the athlete’s sport, training phase, and personal context. Professional guidance is crucial for minimizing risks and optimizing benefits. Further well-designed, long-term studies on athletes are needed to resolve the current controversies. Full article

The ketogenic diet (KD) is a metabolic intervention characterized by high fat and very low carbohydrate intake, showing significant metabolic, neuroprotective, and therapeutic effects. However, its efficacy varies widely due to individual genetic and epigenetic factors. This review synthesizes current knowledge of genes most strongly associated with KD response, including polymorphisms in FTO, APOA2, PPAR, SCN1A, KCNQ2, STXBP1, CDKL5, the MODY gene group, and SLC2A1, which shape outcomes across lipid metabolism, energy expenditure, inflammation, and neurotransmission. Epigenomic modifications induced by a KD, such as changes in DNA methylation and histone acetylation involving BDNF, SLC12A5, KLF14, and others, modulate functional metabolic and neurological effects. Sex and age further modulate KD effects through distinct patterns of gene activation and hormonal interactions. These variables together impact metabolic and neurological outcomes and are critical for developing personalized nutrition and disease management strategies. Based on the reviewed evidence, genetic and epigenetic profiling can help identify patients who are likely to benefit from a KD (e.g., GLUT1DS, PDH deficiency) and those in whom a KD may be ineffective or harmful (e.g., SCOT or SLC2A1-independent defects). The review concludes that genetic and epigenetic profiling is recommended for personalized dietary interventions. Full article

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease, with key features being synovial hyperplasia, autoantibody production, and ultimately cartilage and bone destruction. The pathogenesis of rheumatoid arthritis (RA) is not fully understood, but it is estimated that genetic factors account for 50–60% of the risk, with the remainder attributed to environmental factors, including infectious agents, smoking, gut microbiota, and diet. Given that most current clinical trials on RA and nutrition are limited in sample size and duration, there is an unmet need for higher-quality studies in the future, a need that EULAR has already recognized. Objective: This article aims to investigate the impact of diet and nutritional factors on the development, progression, and potential prevention of RA. Specifically, it provides a comprehensive review of certain foods, such as alcohol, gluten, red meat, and saturated and trans fats, and their contribution to the onset and progression of rheumatoid arthritis (RA). In addition, it examines the effect of key anti-inflammatory nutrients in reducing the risk of RA, including olive oil, fatty fish, juices, and certain fruits. Finally, it discusses the potential protective effects of certain dietary patterns, such as the Mediterranean diet (MD) and diets rich in omega-3 polyunsaturated fatty acids (PUFAs). Methods: A comprehensive literature search was conducted in the PubMed/Medline, Science Direct, and Scopus databases (1990–2025). English-language observational studies, clinical trials, and systematic reviews addressing the relationship between diet and dietary patterns and RA were included. Results: High consumption of red and processed meat, saturated and trans fats, sugary drinks, and gluten (in vulnerable individuals) is associated with increased RA risk and greater disease activity, partly through pro-inflammatory pathways and gut dysbiosis. In contrast, regular intake of olive oil, fatty fish rich in omega-3 polyunsaturated fatty acids, fruit juices, cocoa, certain fruits, and vitamin D appears protective and may reduce disease activity and symptom severity. Adherence to anti-inflammatory dietary patterns, particularly the Mediterranean diet and diets rich in omega-3 fatty acids, is consistently associated with a lower incidence of RA, reduced inflammatory markers, and improved clinical outcomes. However, most available studies are limited by small sample sizes, short duration, heterogeneous methodologies, and potential confounding by other lifestyle factors (e.g., smoking, obesity). Conclusions: Although an appropriate diet and dietary habits cannot replace pharmacological therapy, current knowledge supports the inclusion of an anti-inflammatory diet as an adjunct strategy in the prevention and management of RA. The relatively limited studies that have been conducted suggest that high-quality, large-scale, prospective studies are needed to prevent and treat RA. These studies should incorporate genetic, microbiome, and long-term clinical endpoints, so as to establish definitive dietary recommendations and allow for personalized nutritional interventions for patients with RA. Full article

Background: In pediatric celiac disease (CD), intestinal malabsorption and the restrictive nature of a gluten-free diet (GFD) frequently result in persistent macro- and micronutrient imbalances, despite histological remission. The present review evaluates the evidence on nutritional adequacy of the GFD, identifies common deficiencies, and considers biomarker strategies and dietary recommendations to optimize growth and metabolic health. Methods: A narrative review of the literature was conducted, focusing on studies of nutrient intake, product composition of gluten-free foods, biomarker assessment, and clinical outcomes in children with CD. Both macronutrient (protein, fat, carbohydrate, fiber) and micronutrient (iron, vitamin D, calcium, B-vitamins, zinc, magnesium) domains were included. Results: Children with CD on long-term GFD demonstrate higher intake of lipids (especially saturated fat) and simple carbohydrates, alongside consistently low intake of dietary fiber and key micronutrients. Gluten-free products often exhibit lower protein content, higher glycemic index, and reduced fortification compared to gluten-containing equivalents. Nutritional deficits contribute to impaired linear growth, delayed puberty and increased metabolic risk. Conclusions: Nutritional adequacy of the GFD cannot be assumed in children with CD. Routine monitoring using standardized biomarker panels, combined with personalized dietary counseling and improved formulation and fortification of gluten-free products, is essential to mitigate long-term adverse outcomes. Future work should advance precision nutrition approaches and public-health initiatives to optimize dietary quality in this vulnerable population. Full article

Nutritional assessment and intervention in athletes, a central focus of sports medicine and healthcare, has increasingly shifted in recent years toward precision nutrition—an approach that individualizes dietary recommendations according to genetic profile, microbiome composition, lifestyle factors, and health status. Despite its promising potential, this approach faces significant limitations, including the challenge of integrating complex and dynamic interactions among multilevel indicators, and the relatively high costs associated with omics technologies. The aim of this paper is to propose a nutritional assessment and intervention model grounded in the Network Physiology of Exercise, an emerging scientific field that investigates the horizontal and vertical dynamic interactions among nested physiological levels and conceptualizes athletes as complex adaptive systems (CAS). The proposal integrates social, environmental, behavioral and psychobiological information, extracted particularly from semi-structured interviews based on CAS properties. Accordingly, the traditional dietary assessment tools are replaced by open and guided interviews that allow professionals and practitioners to co-construct meaningful insights and extract qualitative data through a reflexive thematic analysis. From a CAS perspective, the multidimensional and multi-timescale personal and environmental constrains affecting their eating behavior were integrated through a hierarchically nested organization. Eliciting the dynamics of emotional contexts, behavioral patterns, and psychophysiological states, the interviews become both a method of assessment and an intervention in itself. Full article

Background: Chronic kidney disease (CKD) requires strict dietary management tailored to disease stage and individual needs. Recent advances in artificial intelligence (AI) have introduced chatbot-based tools capable of generating dietary recommendations. However, their accuracy, personalization, and practical applicability in clinical nutrition remain largely unvalidated, particularly in non-Western settings. Methods: Simulated patient profiles representing each CKD stage were developed and used to prompt GPT-4 (OpenAI), Gemini (Google), and Copilot (Microsoft) with the same request for meal planning. AI-generated diets were evaluated by three physicians using a 5-point Likert scale across three criteria: personalization, consistency with guidelines, practicality, and availability. Descriptive statistics, Kruskal–Wallis tests, and Dunn’s post hoc tests were performed to compare model performance. Nutritional analysis of four meal plans (Initial, GPT-4, Gemini, and Copilot) was conducted using both GPT-4 estimates and manual calculations validated against clinical dietary sources. Results: Scores for personalization and consistency were significantly higher for Gemini and GPT-4 compared with Copilot, with no significant differences between Gemini and GPT-4 (p = 0.0001 and p = 0.0002, respectively). Practicality showed marginal significance, with GPT-4 slightly outperforming Gemini (p = 0.0476). Nutritional component analysis revealed discrepancies between GPT-4’s internal estimations and manual values, with occasional deviations from clinical guidelines, most notably for sodium and potassium, and moderate overestimation for phosphorus. Conclusions: While AI chatbots show promise in delivering dietary guidance for CKD patients, with Gemini demonstrating the strongest performance, further development, clinical validation, and testing with real patient data are needed before AI-driven tools can be fully integrated into patient-centered CKD nutritional care. Full article

Background/Objectives: Nutrition during the reproductive years shapes women’s immediate health, fertility, pregnancy outcomes, and long-term offspring well-being. This position paper narratively synthesizes and critically appraises evidence on how dietary patterns, macro-/micronutrients, and supplementation influence women’s health, female fertility, and reproductive outcomes, to inform practical recommendations. Methods: We narratively reviewed recent reviews, cohort studies, clinical trials, and public-health guidance on macronutrients, key micronutrients, dietary patterns (with emphasis on the Mediterranean diet), ultra-processed food (UPF) intake, and targeted supplementation relevant to menstrual, metabolic, cardiovascular, skeletal, and reproductive outcomes. Results: Balanced, diverse diets rich in whole and minimally processed foods support hormonal regulation, ovulatory function, healthy gestation, and chronic-disease risk reduction. Priority nutrients include iron, folate, calcium, vitamin D, zinc, vitamin B12, and long-chain omega-3s (DHA), with supplementation considered when dietary intake or bioavailability is inadequate. Evidence consistently links Mediterranean-style eating to improved metabolic health, insulin sensitivity, IVF success, lower gestational diabetes risk, and favorable neonatal outcomes. High UPF consumption is associated with poorer diet quality, inflammation, adverse pregnancy outcomes, and potential reproductive impairment, warranting a reduction in favor of nutrient-dense foods. Diet also influences cardiovascular and bone health through effects on lipids, glycemia, blood pressure, and mineral/vitamin status, with fiber-rich carbohydrates, unsaturated fats (notably olive oil), and adequate calcium–vitamin D emerging as central levers. Conclusions: For women of childbearing age, a Mediterranean-aligned, minimally processed dietary pattern—tailored to individual needs and complemented by prudent use of folate, iron, vitamin D, calcium, B12, and DHA when indicated—offers robust benefits across reproductive, metabolic, cardiovascular, and skeletal domains. Public-health actions should improve access to healthy foods, curb UPF marketing, and embed personalized nutrition counseling in routine care; further longitudinal research from preconception through postpartum is needed. Full article

Hypertension (HTN) and chronic kidney disease (CKD) are significant global health burdens, with microalbuminuria (MA) serving as a key early marker of renal damage and cardiovascular risk. While nutritional interventions are pivotal for management, the evidence for specific nutrients is often complex and inconsistent, creating challenges for clinical guidance. This review critically evaluates current evidence on the interaction among macronutrients, micronutrients, and established dietary approaches and their influence on the development and course of HTN and MA. Strong consensus is present regarding sodium restriction, increased intakes of potassium, and the implementation of dietary patterns like Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet to improve blood pressure and renal outcomes. Evidence favors protein moderation (approximately 0.8 g/kg/day), especially from plant sources, and emphasizes carbohydrate quality (e.g., high fiber, low glycemic index) over absolute quantity. The role of micronutrients is more nuanced; maintaining vitamin D sufficiency is protective, but intervention trials for many supplements, including B vitamins and antioxidant vitamins (C and E), have yielded inconsistent results. Several minerals, such as iron and selenium, exhibit a U-shaped risk curve where both deficiency and excess are detrimental, highlighting the risks of unselective supplementation. Ideal nutrition care prioritizes holistic dietary patterns over a focus on single nutrients. Clinical guidance should be founded on sodium reduction and potassium-rich foods, with personalized recommendations for protein and micronutrient supplementation based on an individual’s specific cardiovascular and renal profile. Future research must target nutrients with conflicting evidence to establish clear, evidence-based intake guidelines. Full article

Background: Precision nutrition increasingly integrates mobile health (mHealth) and artificial intelligence (AI) tools. However, personalized hydration remains underdeveloped, particularly in accounting for both food- and beverage-derived water intake. Objective: This scoping review maps the existing literature on mHealth applications that incorporate machine learning (ML) or AI for personalized hydration. The focus is on systems that combine dietary (food-based) and fluid (beverage-based) water sources to generate individualized hydration assessments and recommendations. Methods: Following the PRISMA-ScR guidelines, we conducted a structured literature search across three databases (PubMed, Scopus, Web of Science) through March 2025. Studies were included if they addressed AI or ML within mHealth platforms for personalized hydration or nutrition, with an emphasis on systems using both beverage and food intake data. Results: Of the 43 included studies, most examined dietary recommender systems or hydration-focused apps. Few studies used hydration assessments focusing on both food and beverages or employed AI for integrated guidance. Emerging trends include wearable sensors, AR tools, and behavioral modeling. Conclusions: While numerous digital health tools address hydration or nutrition separately, there is a lack of comprehensive systems leveraging AI to guide hydration from both food and beverage sources. Bridging this gap is essential for effective, equitable, and precise hydration interventions. In this direction, we propose a hydration diet recommender system that integrates demographic, anthropometric, psychological, and socioeconomic data to create a truly personalized diet and hydration plan with a holistic approach. Full article