Search Results (202)

Background/objective: This study determined the prevalence of dietary behaviours and examined their relationship with nutritional status among Malaysian school-based adolescents. Methods: Data from 33,523 adolescents who participated in the Adolescent Health Survey (AHS 2022) were analysed. Multiple logistic regression was employed to assess associations between dietary behaviours and nutritional status, adjusting for potential confounders. Results: Our findings demonstrated a double burden of malnutrition, with 6.8% stunting, 8.3% thinness, and 30.5% overweight/obese. High prevalence of inadequate daily intake of fruit and vegetables (FV) (83.9%) and insufficient daily dairy consumption (62.7%) was observed. Approximately one-third of adolescents reported frequent fast-food consumption (i.e., at least one day per week) (35.4%) and daily intake of carbonated soft drinks (32.4%). Daily carbonated soft drink consumption was associated with higher odds of overweight/obesity (aOR:1.11; 95% CI:1.04–1.20), highlighting the need to prioritise the public health strategies aimed at reducing sugar intake. Conversely, inadequate FV intake (aOR:0.88; 95% CI:0.81–0.95) and frequent fast-food consumption (aOR:0.87; 95% CI:0.82–0.94) were associated with lower odds of overweight/obesity, while insufficient daily dairy intake was associated with lower odds of thinness (aOR:0.83; 95% CI:0.73–0.94). These negative associations should be interpreted cautiously due to possible reverse causality and reporting bias. Conclusions: The findings highlight the importance of strengthening nutrition education and the food environment among Malaysian adolescents. Full article

Bottled drinking water is widely consumed in Saudi Arabia; however, the chemical composition of these products and the accuracy of the information presented on their labels remain insufficiently characterized. This study evaluated the composition of 41 still bottled waters purchased from major supermarkets in Riyadh, Saudi Arabia, with emphasis on fluoride, calcium, magnesium, sodium, potassium, hardness, and pH, and examined their potential contributions to dietary mineral intake and caries-preventive fluoride exposure. Products were categorized according to label descriptions, and elemental analyses were performed using a fluoride ion-selective electrode for fluoride and ICP-MS for calcium, magnesium, sodium, and potassium. The pH was measured using a calibrated multiparameter analyzer, and hardness was calculated from calcium and magnesium concentrations. Mineral and purified waters accounted for 75.6% of the sampled products. Fluoride concentrations were generally modest (mean 0.76 ppm; median 0.74 ppm), indicating that the potential contribution of bottled water to caries prevention may vary substantially by brand, and only one product would provide the adult adequate intake for fluoride at a hypothetical intake of 2 L/day. Mean concentrations of calcium, magnesium, sodium, and potassium were 15.10, 7.19, 12.08, and 3.55 mg/L, respectively, indicating limited nutritional significance for most products. Most waters were soft to moderately hard, and pH values were close to neutral. Agreement between label declarations and measured values was inconsistent for fluoride, calcium, and pH. These findings show that bottled waters sold in Riyadh differ considerably in composition and that product labels do not always provide a reliable estimate of fluoride content, mineral content, or pH. From a water quality and public health perspective, bottled water can contribute to daily intake of selected constituents, but in most cases, this contribution is modest and highly brand dependent. Full article

Background/Objectives: Overweight and obesity are increasing globally. However, structured contemporary data on lifestyle behaviors and adiposity in Romanian young adults remain limited. Therefore, this study aimed to describe dietary and lifestyle habits, BMI, and overweight/obesity prevalence in Romanian adults aged 18–30 years and to examine associations between these variables. Methods: This cross-sectional online questionnaire study included 1202 young Romanian adults. BMI was calculated from self-reported height and weight and analyzed continuously, as well as for overweight/obesity (BMI ≥ 25 kg/m²). Pre-specified exposures were compulsive eating, soft-drink intake, breakfast frequency, physical activity, and sleep duration. Multivariable linear regression with heteroscedasticity-consistent standard errors was used for BMI, and modified Poisson regression with robust variance was used for overweight/obesity. Composite dietary score, sex-interaction, and sensitivity analyses were also performed. Results: Mean age was 23.2 ± 3.3 years, mean BMI was 23.8 ± 4.2 kg/m², and 32.4% of participants had overweight/obesity. Men had higher BMI and a higher prevalence of overweight/obesity than women. Compulsive eating and soft-drink intake showed dose-dependent associations with higher BMI and higher overweight/obesity prevalence. Short sleep duration (≤5 h/night) and daily breakfast consumption were associated with a higher and, respectively, lower prevalence of overweight/obesity. Physical activity showed no independent association after full adjustment, although this finding may be influenced by the use of a single self-reported item. Composite-score analyses supported the main findings. Conclusions: In Romanian young adults, compulsive eating and soft-drink intake were the most consistent behavioral correlates of adiposity, while breakfast regularity and short sleep showed threshold-type associations with overweight/obesity. These findings may inform the design of multicomponent prevention strategies, although longitudinal confirmation is needed. Full article

Background: Parabens are frequently utilized as preservatives in processed foods; nevertheless, the primary dietary factors contributing to exposure in northern Thailand remain undetermined. Methods: A cross-sectional study was conducted among 130 adults in Northern Thailand. Dietary intake was assessed using self-reported food consumption data combined with previously measured paraben concentrations. Due to the skewed distribution of intake, participants were classified into lower and higher exposure groups. LASSO regression was applied for variable selection, followed by multivariable logistic regression to identify dietary predictors of exposure. Results: Several processed food items were significantly associated with higher paraben exposure, including soft drinks, potato chips, and canned fish. No demographic factors were significantly associated with exposure. The final model demonstrated good explanatory power and classification performance. Conclusions: These findings suggest that routine consumption of certain processed foods and beverages may play a larger role in exposure than individual characteristics, and they highlight practical targets, particularly soft drinks, potato chips, and canned fish, for community-based health-promotion strategies aimed at reducing unnecessary preservative intake. Full article

Background/Objectives: Insufficient hydration and high consumption of sugar-sweetened beverages (SSBs) is a significant public health challenge among adolescents. The aim of the presented study was to assess the beverage intake, in terms of quantity and choices, in a national-based population of Polish adolescents within the PLACE-19 Study. Methods: Within the PLACE-19 Study, the population of n = 1027 secondary school adolescents (age 15–20 years) was recruited based on a quota sampling of Polish secondary schools and n = 984 individuals (n = 674 female, n = 310 male) were included in the analysis. The study assessed beverages intake using the National Youth Physical Activity and Nutrition Study (NYPANS) survey questionnaire and data were gathered using the Computer-Assisted Web Interview (CAWI) technique. The beverages were assessed in the following groups: water, milk beverages, 100% fruit juices, coffee/tea, regular carbonated soft drinks (CSDs), diet CSDs, other sugar-sweetened beverages (SSBs); additionally, total SSBs were summarized. The total beverage intake was compared with 80% of the Adequate Intake (AI) level. Results: The highest intake was observed for water (250 mL per day), and tea beverages (178.1 mL per day). However, in combining SSBs, the total daily intake for this group was 394.4 mL per day. The highest share of the daily intake of beverages was attributed to water intake (23.81%), and tea beverages (11.45%), followed by 100% fruit juices (7.14%), fruit drinks (6.67%), and milk (6.45%); however, the intake of total combined SSBs was even higher than for water (32.47%). Male individuals were characterized by a higher share of milk beverages, regular CSDs, diet CSDs, and other SSBs than female ones, while female individuals were characterized by a higher share of water, and coffee/tea in their total daily beverage intake than male ones (p < 0.001). Younger individuals were characterized by a higher share of other SSBs in their total daily beverage intake than older ones (p = 0.034). For the vast majority of the studied group, the inadequate intake of beverages was observed, as over 70% of the studied sub-groups did not meet the AI value. Conclusions: The inadequate beverage intake in a population of adolescents may be a problem, especially considering high intake of SSBs, and relatively low intake of water. Especially in male and younger individuals, due to a higher intake of SSBs, than for female and older individuals, education is necessary to promote adequate intake and choices of beverages. Further research is needed in the area of beverage consumption to understand the determinants of beverage consumption and develop opportunities to improve it. Full article

Background and Objectives: Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder that significantly affects quality of life. Night eating syndrome (NES), characterized by evening hyperphagia and nocturnal eating, may worsen reflux through delayed gastric emptying and increased nocturnal acid exposure, yet evidence in young adults remains limited. This study aimed to estimate the prevalence of GERD and NES, examine their association, and identify clinically relevant predictors among adults in southern Saudi Arabia. Methods: A cross-sectional study was conducted among 831 adults (≥18 years) in the Jazan region between November 2024 and April 2025. Data were collected using a validated 54-item online questionnaire assessing sociodemographic characteristics, lifestyle behaviors, dietary habits, and medical history. GERD was defined using the GerdQ (score ≥ 8), and NES using the night eating questionnaire (NEQ ≥ 25). Multivariable logistic and linear regression analyses were performed to identify independent predictors. Results: The prevalence of GERD was 25.6%, and 9.7% of participants met the criteria for NES. Higher NEQ scores were independently associated with increased odds of GERD (OR = 1.05, 95% CI: 1.02–1.07; p = 0.001). GERD was predicted by tea consumption, middle income (10,000–14,999 SAR), asthma, hiatal hernia, and a family history of GERD. NES was independently associated with GERD, smoking, and frequent intake of fatty foods, chocolate, salty foods, and soft drinks, while male sex, employment or student status, higher income, and fiber-rich food intake were protective. Conclusions: NES is significantly associated with GERD among young adults. Integrating screening for disordered eating behaviors and dietary counseling into routine GERD care may improve clinical outcomes. Full article

Background: Studies outside Japan have linked sugar-sweetened beverage (SSB) intake with weight gain; however, evidence in Japanese adults is scarce, and no study has examined beverage-derived energy in relation to anthropometric indices and handgrip strength. Methods: The participants were employees of Fujita Health University aged 20–39 years (n = 76; male n = 35, average age: 29.97 ± 4.67 years; female n = 41, average age: 27.29 ± 4.53 years). Energy from beverage intake was assessed via the Brief Beverage Intake Questionnaire-15, and energy from alcoholic drinks, milk, SSBs, and total beverages was calculated. The associations of energy from different beverages with nutrient intake, BMI, skeletal muscle mass index (SMI), and handgrip strength were analyzed via ordinary least squares (OLS) regression; quantile regression (QR) and the generalized additive model (GAM) were used for sensitivity analyses. Results: Increased SSB intake was associated with increased BMI (standardized β = 0.35, 95% CI 0.12–0.58, p(OLS) < 0.001; p(QR) = 0.23; p(GAM) < 0.001) and was nonlinearly associated with increased SMI (standardized β = 0.21, 95% CI 0.043–0.37, p(OLS) = 0.02; p(QR) = 0.11; p(GAM) = 0.02), even after adjustment for total energy intake. Modest milk intake was linked to higher protein intake and a higher SMI without a higher BMI (standardized β = 0.18, 95% CI 0.020–0.35, p(OLS) = 0.03; p(QR) = 0.39; p(GAM) = 0.03). Conclusions: A positive association was found between SSB intake and both BMI and SMI and between MILK intake and SMI. Clarification in larger, diverse Japanese populations will be necessary. Full article

Beverages, particularly sugar-sweetened beverages (SSBs), pose a significant public health concern globally. Changing eating habits among Pakistani young adults have led to higher sugary drink consumption, underscoring the need for a suitable cultural assessment tool. A cross-sectional study was conducted among 381 university students aged 18–26 years from three major cities of Pakistan. Following World Health Organization (WHO) guidelines, the original Beverage Intake Questionnaire (BEVQ-15) was modified by removing four items (including alcoholic beverages), adding two culturally relevant types (flavored milk and refreshing drinks), and converting measurement units to milliliters, resulting in a 13-item Beverage Intake Questionnaire-Pakistan (BEVQ-PK). Validity was assessed by comparing BEVQ-PK1 (test) with three 24 h dietary recalls. Test–retest reliability was evaluated after a 14-day interval by comparing BEVQ-PK1 (test) and BEVQ-PK2 (retest). Analyses included descriptive statistics, paired sample t-tests, Intraclass Correlation Coefficients (ICC), Bland–Altman plots, and Spearman’s correlations. The BEVQ-PK (13-item) demonstrated moderate to strong validity (r = 0.2–0.8, p < 0.001) and strong reliability (r = 0.5–0.9, p < 0.001). Most beverage categories showed no significant intake differences between test and retest. Tea/coffee with milk was the most frequently consumed beverage, followed by soft drinks and green/black tea. Overall, BEVQ-PK is a valid and reliable tool for assessing SSB intake among Pakistani university students and can support future nutrition and public health research. Full article

Background/Objectives: Food cravings are common with high-palatability foods that are high in sugar and/or fat. Food cues can strongly induce food craving, and heightened food cue reactivity is associated with eating disorders and obesity. Sweet taste signalling is suggested to be an important regulator of appetite and food intake, with sensory-metabolic mismatch potentially relevant for the food craving experience. This study investigated the interaction between taste and food cues and food craving in healthy people with and without ingestion of a sugary drink. Methods: This study had a randomised crossover design with 47 healthy individuals who participated in two experimental trials. Fasted individuals were exposed to food cues, and food craving pre- and post-exposure was measured via a newly validated method using handgrip force as a response modality. This was followed either by ingestion (ingestion trial) or mouth rinse (mouth rinse trial) of a sugary drink and reassessment of food cue craving responses. Continuous interstitial glucose monitoring was performed using a glucose sensor inserted into the upper arm, and a blood sample for leptin levels was taken. Results: A strong food craving response to food cues was bound to the fasted state, while ingestion of a sugary drink blunted food cue reactivity and reduced craving levels. Mouth rinse induced a stable increase in food craving, which reached a maximum after food cues. Interstitial glucose levels over the after-trial periods (incremental area under the curve, iAUC) were significantly higher for the rinse trial day than for the ingestion trial day, which may suggest higher carbohydrate/sugar intake after the rinse trial, while craving levels were associated with iAUC in the rinse trial. Conclusions: Outcomes indicate that taste/flavour in connection with food cues may generate an error signal experienced as food craving, whereas receipt of sugars, with concomitant physiological responses, reduces the signal and diminishes food craving. These results highlight the importance of sensory-metabolic mismatch in the food craving experience. Full article

Dietary pattern characterized by low intake of vegetables and fruits and high consumption of fat, soft drink and desserts are associated with an increased risk of chronic diseases. To investigate the effects of folate status and fructose intake on adenine-induced chronic kidney disease (CKD), seven-week-old C57BL/6 mice were divided into six groups and fed either a control diet (Ctrl), a 26% (w/w) high-fructose diet (Hfru), Ctrl plus 0.15% adenine (Ctrl+ade), Hfru+ade, Hfru with folate deficiency plus adenine (Hfru−f+ade), or Hfru with tenfold folate supplementation plus adenine (Hfru+f10+ade). After 10 weeks on the assigned diets, adenine was administrated to the +ade groups for 7 weeks. The results showed that all adenine-treated mice exhibited increased fasting blood glucose, urinary glucose, and elevated renal expression of collagen 1a1 (Col1a1), fibronectin (Fn1), and smooth muscle α-actin (Acta2). Compared with Ctrl mice, Hfru-fed mice showed significantly higher serum creatinine, increased urinary protein, and reduced creatinine clearance. Adenine induced kidney injury in all +ade groups, with the most severe damage observed in Hfru−f+ade mice, as indicated by elevated blood urine nitrogen (BUN), urinary protein, neutrophil gelatinase-associated lipocalin (NGAL), and renal fibrosis. In contrast, Hfru+f10+ade mice showed the lowest levels of these renal injury markers. The Hfru+ade diets increased renal Hif1α and iNos gene expression, which was further exacerbated by folate deficiency. Secretion of the anti-inflammatory cytokine interleukin (IL-10) by splenocytes was significantly reduced under folate-deficient conditions. Renal IL-10 levels were suppressed in all +ade groups but were significantly increased by folate supplementation. Renal IL-10 levels were negatively correlated with the inflammatory chemokine monocyte chemoattractant protein (MCP-1) and transforming growth factor (TGF)-β, whereas renal MCP-1 levels showed positive correlations with TGF-β and IL-6. Overall, these findings suggest that high fructose consumption in the absence of adequate folate intake may be of concern for CKD progression. Full article

Background/Objectives: Within public health and preventive nutrition, food labeling plays a critical role in supporting healthier dietary behaviors. This study aimed to evaluate the behaviors, perceptions, and nutritional literacy of young adults from Iași, Romania, regarding simple carbohydrates (SCHO) consumption and food label-reading habits. Materials and Methods: A cross-sectional survey was conducted between May–June 2023 using 20-item Likert-scale questionnaire completed by 150 participants aged 18–30 years. Statistical analysis included descriptive metrics, Chi-square tests, and Pearson’s correlation, with significance set at p ≤ 0.05. Results: The cohort consisted of 72% females (N = 108) and 28% males (N = 42), with 42.7% (N = 64) holding university degrees. Although 22% (N = 33) considered SCHO consumption highly important, only 13.3% (N = 20) frequently read nutrition labels (p ≤ 0.05). Dietary patterns showed that 27.3% primarily consumed sweets, while others combined sweets with carbonated beverages, dairy products, or whole grains; overall, 44% (N = 66) reported frequent sweet consumption. Label reading was highest for sweets (40.7%), lower for dairy products (19.3%) and soft drinks (9.3%). Additionally, 30.7% (N = 46) checked only expiration dates, whereas just 11.3% (N = 17) reviewed nutritional content. Trust in label accuracy was low: 48% (N = 72) expressed neutrality and 14% (N = 21) disagreed. Although 77.3% (N = 116) recognized the link between sugar intake and dental caries, only 23.3% (N = 35) felt well informed about oral health risks. Taste dominated food selection (68.7%), while nutritional value was cited by 16.7% (N = 25). Conclusions: Young adults from Iași demonstrated notable gaps in nutritional literacy and suboptimal dietary behaviors, emphasizing the need for structured educational strategies to improve preventive practices relevant to systemic and oral health. Full article

Background: Beverage intake is a consequential yet underappreciated driver of health in Mediterranean settings. Comparative evidence for Spain and Italy based on harmonised measures is scarce. This study addresses that gap by profiling beverage portfolios and their sociodemographic correlates in parallel adult samples from both countries. Methods: We conducted a cross-sectional analysis of adults in Spain (n = 483) and Italy (n = 403) using aligned, validated instruments (NutSo-HH; NutSo-HH-Ita). Outcomes were water (Wtr), sugar-sweetened soft drinks (Sfd), juice (Juc), energy drinks (End), coffee (Cff), alcohol (Alc), and episodes of intoxication (Gtd). Associations were assessed via non-parametric tests, multivariable linear models, and an EBIC-selected Gaussian graphical model (GGM). Main results: Italians reported higher Alc and Gtd; Spaniards reported higher Sfd and Juc. Wtr was comparable across countries, and Cff differences were marginal. Age and sex emerged as the most consistent correlates (older age and male sex with higher Alc; younger age with higher Sfd), whereas education and income were not stable determinants. The GGM suggested behavioural clustering of Sfd–Juc–End, with weak partial correlations for other beverages after adjustment. Implications: Distinct country profiles imply differentiated priorities. In Spain, interventions could prioritise reducing sugar-sweetened beverage intake among younger adults through age-targeted primary care counselling, mandatory water (and unsweetened milk) availability in schools, tiered excise taxes on sugar-sweetened drinks, and restrictions on child- and youth-directed marketing of high-sugar beverages. In Italy, primary care and community health services could routinely screen adults for risky alcohol use and deliver brief, culturally attuned advice that promotes lower-risk patterns of wine consumption during meals. Given the cross-sectional design, self-report measures, and non-probabilistic sampling, findings should be interpreted as context-sensitive markers rather than causal determinants; nevertheless, they highlight concrete prevention approaches and regulatory levers for each country’s beverage-related health risks. Full article

The increasing consumption of artificially sweetened beverages among young people, coupled with prevalent digital technology use, presents growing public health concerns regarding potential effects on health and behavior. This study aimed to determine the concentrations of three commonly used artificial sweeteners—acesulfame K, saccharin, and aspartame—in soft drinks available on the market in Osijek, Croatia, to assess their compliance with European Union regulations, and to investigate the consumption patterns and possible associations with internet addiction among university students. Laboratory analysis of 43 beverages was performed using high-performance liquid chromatography with diode array detection, while a cross-sectional survey of 792 students collected data on sociodemographic characteristics, beverage consumption, and internet use. Acesulfame K was the most frequently detected sweetener, followed by aspartame and saccharin, with mean concentrations of 50.1 mg/L, 22.7 mg/L, and 19.76 mg/L, respectively. Overall, 85.7% of the students stated that they consumed artificially sweetened drinks, with an average consumption of 0.2 L/day. Internet addiction was found in 39.8% of the participants, but no significant correlation was found between beverage consumption and internet addiction (p = 0.177). All measured concentrations of sweeteners were below the legal limits. These results suggest that while exposure to artificial sweeteners in beverages is within safe limits, further research is needed to assess cumulative intake and its potential impact on behavioral health in young adults. Full article

Introduction: Consumption of ultra-processed food (UPF) is associated with poor diet quality and a risk for non-communicable diseases (NCDs). This study explores the energy contribution of NOVA foods and the nutrient gaps. Methods: The study sourced data from the previous Ethiopian National Food Consumption Survey (NFCS). It covered 8254 households, 8254 women of reproductive age (15–45 years old), and 7272 children (6–45 months old). Results: The most consumed UPF in children were biscuits, cookies, soft drinks, and semi-solid palm oil; while cow and human milk, whole wheat bread, a range of legumes, tubers, and cereal-based foods were among NOVA1. In both children and women, the largest dietary energy intake was from NOVA1 (74.6% and 79.0%), processed culinary ingredients (18.3% and 14.0%), processed foods (1.9% and 3.5%), and UPF (5.1% and 3.5%), respectively. Higher intake of energy from UPF was found in urban residences, wealthier households, and women with higher education. However, NOVA1 was more dominantly consumed in rural than in urban areas. Micronutrient and macronutrient gaps were observed compared to the recommended nutrient intake (RNI). The intake of fruits and vegetables was also considerably low compared to the WHO recommendation (≥400 g/day for adults, and ≥250 g/day for children). Conclusions: Adequate intake of micronutrients, fruits, and vegetables is essential to meet the RNI and could have reduced existing body micronutrient deficiencies, such as vitamin A, zinc, iodine, calcium, vitamin D, and selenium prevalence. Whether UPF intake in urban areas is associated with insufficient availability and access to NOVA1 foods or just due to the higher provision of UPF and gained popularity needs additional investigation. Further study is recommended to simulate the impact of increased fruits and vegetables and/or reduced intake of selected UPF, salts, and oils on NCD markers or mortality in the country. Full article

Background/Objectives: This study aimed to assess the consumption of caffeinated beverages and the associated caffeine intake among Saudi adults, alongside a quantitative risk assessment using the hazard quotient (HQ) approach. Methods: A cross-sectional study was conducted, utilizing a validated Arabic Beverage Frequency Questionnaire to collect data on beverage consumption patterns. The participants reported the type, frequency, and quantity of caffeinated beverages consumed. We also calculated caffeine intake and assessed the associated health risks. Data were collected from 4367 participants across 13 regions in Saudi Arabia. Results: This study involved adult participants (18–65 years), with 45% females and 55% males. The mean age of the participants is 35 years. The participants reported the type, frequency, and quantity of caffeinated beverages consumed through a self-reported online survey. The most commonly consumed caffeinated beverages were Saudi coffee (79%), soft drinks (75%), and sweetened tea (69.3%). The highest consumption was observed in the 30–44 age group. The mean daily caffeine intake was 131 ± 1.4 mg/day (145 ± 2.3 mg/day for males, 120 ± 1.8 mg/day for females). Although female participants consumed more beverages, male participants had higher caffeine intake (p = 0.000). The mean HQ for caffeine exposure was 0.32, with a 95th percentile of 0.33, indicating no significant risk. Pregnant and lactating women’s caffeine intake also remained within safe limits. Conclusions: The average caffeine intake among Saudis is below 400 mg/day, suggesting no immediate health concerns. However, public health initiatives should focus on educating specific population groups about the safe limits of caffeine consumption. Full article