Search Results (116)

Background and Objectives: A provegetarian (PVG) food pattern, also known as a plant-based food pattern, which prioritizes the consumption of plant-based foods without completely excluding animal-based foods has been associated with health benefits. However, not all plant-based foods are healthy. We prospectively evaluated the association between different PVG food patterns and the risk of total mortality in the “Seguimiento Universidad de Navarra” (SUN) cohort. Methods: The SUN Project is a Mediterranean cohort study involving Spanish university graduates. A validated 136-item semi-quantitative food frequency questionnaire was used. A PVG food pattern, as previously proposed, was calculated assigning positive scores to plant-based foods and inverse scores to animal-based foods. Participants were categorized into quintiles based on their adherence to this pattern. Additionally, healthy and unhealthy PVG food patterns were derived. Results: Data from 17,989 participants with a mean baseline age (standard deviation) 38 (±12) years were analyzed. Over a mean follow-up period of 12 years, 460 deaths (2.6%) were recorded. Participants with higher adherence to the PVG food pattern (Q5) exhibited a 32% lower risk of total mortality [hazard ratio (HR): 0.68 (95% CI: (0.50–0.93); p for trend = 0.020] as compared to those with lower adherence (Q1), after adjusting for multiple confounders. This inverse association persisted for the healthy PVG food pattern [HR: 0.65 (95% CI: 0.47–0.90); p for trend = 0.016]. In contrast, the unhealthy PVG food pattern did not show any significant association with mortality [HR: 1.31 (95% CI: 0.94–1.83)]. Conclusions: Higher adherence to a PVG food pattern, which emphasizes the consumption of plant-based foods, reduces the risk of total mortality in the SUN cohort. Full article

Background: Western dietary patterns worldwide are increasingly dominated by energy-dense, nutrient-deficient industrial foods, often identified as ultra-processed foods (UPFs). Such products may have detrimental health implications, particularly if nutritionally inadequate. This study aimed to examine the intake of unhealthy UPFs among children and adolescents from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) involved in the DELICIOUS project and to assess the association with dietary quality indicators. Methods: A survey was conducted with a sample of 2011 parents of children and adolescents aged 6 to 17 years to evaluate their dietary habits. Diet quality was assessed using the Youth Healthy Eating Index (Y-HEI), the KIDMED index to determine adherence to the Mediterranean diet, and compliance with national dietary guidelines. Results: Increased UPF consumption was not inherently associated with healthy or unhealthy specific food groups, although children and adolescents who consumed UPF daily were less likely to exhibit high overall diet quality and adherence to the Mediterranean diet. In all five countries, greater UPF intake was associated with poorer compliance with dietary recommendations concerning fats, sweets, meat, and legumes. Conclusions: Increased UPF consumption among Mediterranean children and adolescents is associated with an unhealthy dietary pattern, possibly marked by a high intake of fats, sweets, and meat, and a low consumption of legumes. Full article

Background: Culinary habits and knowledge play a key role in shaping dietary behaviors and overall health. In Spain, societal changes have led to a decline in traditional Mediterranean practices and, in some cases, to unhealthy lifestyles. This study explores the relationship between culinary habits, knowledge, and health behaviors among adults in Spain. Methods: A cross-sectional study was conducted with 1534 participants using validated questionnaires to assess culinary habits, knowledge, and lifestyle factors. Data were collected online via snowball sampling and analyzed using the Kruskal–Wallis test and a Gaussian graphical model to explore variable associations. Results: Participants with healthy culinary habits reported higher self-perceived health and greater fruit and vegetable consumption, while those with unhealthy habits consumed more fast food. Higher culinary knowledge was linked to better dietary choices, more vegetables and cereals, and lower smoking rates. Higher home cooking frequency was moderately correlated with the use of healthy cooking techniques. The network analysis showed that the frequency of cooking at home is positively associated with gender and age. A similar association was found for time spent cooking. Positive associations were also found between living with the family and time spent cooking, while age showed a negative correlation with living situation. Centrality measures identified influential variables within the network. Conclusions: Culinary knowledge and habits strongly influence health behaviors. Network analysis underscores the importance of specific variables such as cooking frequency and living situation in shaping lifestyle patterns. Educational programs aimed at enhancing culinary skills could promote healthier eating behaviors and mitigate public health risks. Full article

Background: Adolescence is a pivotal developmental stage marked by physiological and behavioral changes that significantly influence dietary habits and long-term health outcomes. Objectives: This study aimed to examine the associations between socio-demographic characteristics, psychological factors, and dietary behaviors among school-aged children and adolescents in Romania. Methods: A cross-sectional study was conducted using a structured, self-administered questionnaire completed by 662 children and adolescents aged 6 to 18 years, enrolled in primary, middle, and high schools across urban and rural areas. The questionnaire evaluated nutritional intake, meal patterns, hydration habits, physical activity, screen time, and psychological factors such as fatigue, stress, and mood fluctuations. Body mass index (BMI) was calculated based on self-reported height and weight. Results: The analysis reveals significant gender differences in body mass index (BMI), weight-loss behaviors, and family structure. Female adolescents were more likely to be underweight (18.27%) compared to male adolescents (10.82%), while overweight prevalence was higher among male adolescents (18.66%) than female adolescents (11.68%) (χ² = 11.457, p = 0.009). Dietary patterns varied significantly across age groups, with high-school-aged children demonstrating lower vegetable consumption and increased autonomy over food choices. Primary school children exhibited higher intake of carbonated beverages (OR = 0.185, p = 0.002 for high school; OR = 0.116, p < 0.001 for middle school), whereas teenagers showed a preference for structured meals and lower fast-food intake. Meat consumption frequency correlated with greater diversity in protein sources (χ² = 48.77, p < 0.001), while chaotic eating behaviors were more prevalent among middle and high-school-aged children (OR = 2.291, p = 0.032 for middle school; OR = 2.225, p = 0.030 for high school). Hydration habits played an essential role in dietary quality, with school-age children consuming ≥ 3 L of water daily exhibiting healthier eating patterns (OR = 7.146, p = 0.001). Additionally, psychological factors such as fatigue and stress were significantly associated with unhealthy dietary choice. Conclusions: These findings highlight the need for targeted nutritional education, school-based interventions, and family-focused strategies to improve adolescent health behaviors. Full article

Background/Objectives: Dietary patterns rich in plant-based foods during pregnancy have been associated with neurodevelopmental outcomes in offspring. However, not all components of these diets are healthy, and the impact of their quality on behavioral outcomes remains unexplored. Therefore, this study aimed to examine the association between healthy and unhealthy plant-based diets and offspring behavioral problems at the age of four. Methods: This research involved 201 mother–child pairs from the ECLIPSES study. Maternal diet during pregnancy was assessed using a validated food frequency questionnaire, from which the healthy plant-based diet index (hPDI) was calculated, emphasizing the consumption of fruits, vegetables, legumes and nuts, along with the unhealthy plant-based diet index (uPDI), highlighting the intake of sugary drinks and refined grains. Children’s behavior was evaluated using the Child Behavior Checklist 1.5-5. Multivariable logistic regression analyses were conducted to estimated odds ratios (ORs) and their 95% confidence intervals (CIs). Results: Greater adherence to the uPDI during pregnancy was associated with higher odds for externalizing problems, including attention-deficit/hyperactivity problems (OR = 1.08; 95%CI from 1.01 to 1.16) and oppositional defiant behavior (OR = 1.09; 95%CI from 1.00 to 1.19) in offspring, particularly girls. Higher adherence to the hPDI was not associated with children’s behavior. Conclusions: The consumption of unhealthy components of a plant-based dietary pattern during gestation has been associated with adverse behavioral outcomes in children at age four. These findings underscore the importance of discerning between the healthy and unhealthy components of plant-based diets when assessing their impact on child development. Full article

Background: While unhealthy dietary trends, such as elevated confectionery consumption and decreased fruit intake, have been documented in adults, the longitudinal patterns of food consumption during childhood remain inadequately characterized. This study aimed to describe national trends in food group intakes among children and adolescents in Japan. Methods: Data on participants aged 1–19 years in the National Health and Nutrition Survey from 2001 to 2019 (n = 37,072) were used in this study. A 1-day, semi-weighed, household-based dietary record was used to assess dietary intake. Results: Decreasing trends in the intakes of animal-based foods, potatoes and starches, sugars and sweeteners, fruits (annual percentage change [APC] range: −5.04 to −0.62), algae, fish and shellfish (APC range: −3.22 to −2.02), eggs, milks, fats and oils, and confectionery were observed, while intakes of meats (APC range: 1.02 to 1.92) and beverages (APC range: 1.36 to 2.51) increased. Consumption of plant-based foods, cereals, legumes, nuts and seeds, vegetables, and mushrooms was mostly unchanged, whereas variable intakes of seasonings and spices were observed. Conclusions: This study showed that the intakes of many food groups (e.g., fruits, fish and shellfish, and milk) decreased among children and adolescents, but some increased (e.g., meats and beverages) or remained stable (e.g., cereals and vegetables). Further evidence is needed to enable policymakers to set target interventions to improve children’s diets. Full article

Background: Television (TV), video games, PC and devices such as tablets and smart phones have become part of everyday life at an ever-younger age. Increased screen time correlates with unhealthy eating habits among children. Methods: 374 children aged 9–12 years and their parents (n = 159), from 3 schools in Lemnos and 5 schools in Thessaloniki, Greece, took part in this cross-sectional study. The children completed the KIDMED score and a questionnaire about their physical activity, time spent watching TV, PC and playing electronic games, the frequency of cooking or shopping with their parents, the frequency of eating fast food, soft drinks and Functional Foods (FFs). Statistical analysis was performed with SPSS-29.0, using One Way ANOVA and Pearson chi-square. Results: As the hours of TV viewing increased, so did the percentage of children who consumed soft drinks (p = 0.03). A statistically significant association detected between television (p = 0.024), video games (p = 0.028), all screen categories (p = 0.011) and fast-food consumption. Increased screen time is associated with a higher weekly consumption of fast food (p = 0.011). The more hours children spent in front of screens, the less adherence they had to the Mediterranean Diet (p = 0.001) and less natural FFs consumption (p = 0.001). Conclusions: The results suggest that screen time seems to affect children’s eating behaviors. The study concluded that the longer the screen time, the unhealthier the dietary habits of schoolchildren become. Future research should focus on reducing screen time, as a means of improving dietary patterns and potentially reducing childhood obesity. Full article

A body of evidence indicates an association between ultraprocessed foods (UPFs) and health outcomes. Most of it has been obtained through preclinical studies, although a number of observational studies substantiate how a high intake of these products increases the risk of neuropsychiatric disorders, and an increasing amount of dietary intervention studies confirm these findings. The aim of this narrative review is to describe some of the putative mechanisms involved in the deleterious effects of a high intake of UPFs on neuropsychiatric outcomes. A myriad of unhealthy actions may be associated with the consumption of UPFs, and some mechanisms are being discussed. They include UPFs’ high caloric density; their high sugar, sodium, and additives content and low amounts of fiber; and a high palatability that induces overconsumption, acting as obesogens. Moreover, thermal treatment of these foods generates oxidative products such as glycotoxins, lipotoxins, and acrolein, all of which affect the brain. The chemical products act, directly or indirectly, on the gut microbiome and affect the gut–brain axis, causing neuroinflammation, oxidative stress, and neurodegeneration. UPFs also exert various epigenetic effects that affect mental health and might explain the intergenerational inheritance of neuropsychiatric disorders. A diet containing a high proportion of these foods has a low nutritional density, including bioactive protective agents such as antioxidant and anti-inflammatory compounds that promote eubiosis. The evidence shows that UPFs intake affects neuropsychiatric outcomes such as neurodegeneration, cognitive decline, dementia, and mood disorders and reinforces the need to promote a healthy dietary pattern throughout all life stages, thus interfering with the current commercial determinants of health. Full article

This research aims to explain the role of food processing in improving the sustainability of food security under the framework of ‘Goal 2’ associated with the Sustainable Development Goals (SDGs). The research methodology relied on descriptive and quantitative analysis methods, where the VAR model was used. The key findings reveal that food manufacturing reduces malnutrition rates and increases the level of exports and capital investment, contributing to enhancing the level of sustainability of food security in the Kingdom of Saudi Arabia (KSA). Increasing food production reduces the prevalence of severe food insecurity. Malnutrition in the KSA is not due to a shortage in production of food quantities; rather, it is due to the consumption pattern of the population, and unhealthy food habits and traditions. The food production index does not cause a difference between exports and imports, as there is no dependence of imports and exports on food production. Likewise, the food production index does not cause a change in the value of capital investment in food and beverage factories. The increase in food production and, investment in food processing, and the decrease in the difference between food imports and exports by 10% for one lag period led to a decrease in the proportion of malnourished people in the total population by about 0.25%, 1.7%, and 1.33%, respectively. Moreover, these variables led to a decline in the prevalence of severe food insecurity by 0.3%, 0.66%, and 0.4%, respectively, and led to an increase in the food production index by 1.62. The study recommends that more emphasis should be given to increasing food processing and encourages local and foreign investment in this area to maintain sustainable food security indicators in the KSA. Full article

Background/Objectives: This study examines the relationship between visceral fat (VF), metabolic health, and dietary patterns in patients with obstructive bronchial diseases (OBDs) using bioelectrical impedance analysis (BIA). Methods: A total of 75 patients diagnosed with OBD, including chronic obstructive pulmonary disease (COPD) and/or asthma, were assessed for VF levels via BIA. Dietary habits were evaluated using a structured questionnaire to explore their correlation with VF accumulation. Results: The study cohort comprised predominantly male participants (66.7%), with the majority aged between 61 and 70 years (46.7%). Significant gender differences in VF distribution were observed, with 60% of females maintaining normal VF levels (1–9) compared to only 28% of males, while 38% of males exhibited very high VF levels (15–30; p = 0.003). Body mass index (BMI) showed a strong correlation with VF (p < 0.0001), as overweight and obese individuals predominantly displayed elevated VF levels (≥10). Moreover, metabolic syndrome (MS) was present in 66.7% of participants, with these individuals exhibiting significantly higher VF levels compared to those without MS (p = 0.001). Dietary analysis revealed that frequent consumption of fast food (r = 0.717, p < 0.001), carbonated drinks (r = 0.366, p = 0.001), and refined carbohydrates (r = 0.438, p < 0.001) was significantly associated with increased VF accumulation. Conversely, higher intake of water (r = −0.551, p < 0.001), fruits (r = −0.581, p < 0.001), and vegetables (r = −0.482, p < 0.001) correlated with lower VF levels. Lack of physical activity was also strongly linked to VF accumulation (r = 0.481, p < 0.001), further reinforcing the role of lifestyle factors in metabolic health. Conclusions: The findings underscore the significant impact of dietary habits and physical activity on VF accumulation in OBD patients. BMI and MS emerged as critical predictors of VF, while unhealthy dietary patterns and sedentary lifestyles further exacerbated VF deposition. Elevated VF levels were linked to adverse lipid profiles, reinforcing the need for dietary and lifestyle modifications in managing metabolic health among OBD patients. Although no direct association was identified between VF and forced expiratory volume in one second (FEV1), the results highlight the necessity of integrated nutritional and metabolic interventions in the management of chronic respiratory diseases. Full article

Background: Unhealthy food consumption in long-term care facilities (LTCFs) contributes to poor health outcomes among residents. This study aimed to assess its prevalence, identify demographic and physical risk factors, and propose targeted interventions. Methods: A mixed-methods study (2017–2021) analyzed data from 1000 Polish LTCF residents (aged 35–105 years). Anthropometric measurements, bioimpedance analyses, dietary assessments, and physical activity records were collected. Food items were classified as “healthy” or “unhealthy” using an AI-based Large Language Model (LLM), applying WHO guidelines and the NOVA classification system. Logistic regression and chi-square tests assessed associations between unhealthy food consumption and marital status, education level, mobility aid use, and portion control. Results: Unhealthy food consumption prevalence was 15.6%. Married residents had significantly higher rates than unmarried individuals (22.6% vs. 14.3%, p < 0.01). Lower educational attainment correlated with increased risk (partial primary education: 34.7% vs. tertiary education: 8.1%). Mobility aid users exhibited elevated consumption (cane: 34.6%; walker: 22.6%). Poor portion control showed the strongest association (OR = 3.2, 95% CI: 1.8–5.7). Conclusions: Marital status, educational disparities, mobility limitations, and portion control were key modifiable risk factors. Findings suggest the need for targeted nutrition programs, caregiver education, and policy reforms to improve dietary literacy and meal portioning. Future research should validate AI-based food classification methods, assess long-term intervention outcomes, and expand studies to diverse LTCF settings. These findings align with Poland’s National Health Programme and provide actionable insights for global LTCF populations. Full article

Background: Adolescence is a crucial stage when young people adopt various lifestyle behaviours that can impact their health. However, the broader determinants of these behaviours remain underexplored. This study aimed to investigate clustering patterns of lifestyle behaviours, including physical activity, sedentary behaviour, and dietary habits, among adolescents and examine their determinants across individual, community, and societal levels. Methods: This study utilised nationally representative Global School-based Student Health Survey data. The lifestyle behaviours were dichotomised based on specific definitions, and the clustering patterns of multiple unhealthy behaviours were compared at various levels of factors. Multilevel logistic regression analysis was employed to identify individual, community, and societal level determinants of multiple unhealthy behaviours. Results: The study included 293,770 adolescents from 73 countries and territories across five World Health Organization (WHO) regions. The overall prevalence of one, two, three, four, and five unhealthy behaviours was 6.9%, 29.9%, 36.5%, 21.5%, and 4.5%, respectively. The odds of multiple unhealthy behaviours (defined by ≥4) increase with age and are higher among female adolescents [(AOR: 1.06, 95% CI:1.05, 1.07); (AOR: 1.16, 95% CI: 1.14, 1.19)], respectively. Adolescents from supportive families, peer environments, or food-secure households had lower odds of engaging in these behaviours [(AOR: 0.84, 95% CI: 0.82, 0.86); (AOR: 0.96, 95% CI: 0.94, 0.98); (AOR: 0.91, 95% CI: 0.87, 0.95)], respectively. The odds of exhibiting multiple unhealthy behaviours were significantly higher among adolescents in countries with high (0.7–0.79) and very high (0.8–1.0) Human Development Indexes (HDI) compared to those in low (<0.55) HDI countries [(AOR: 1.84, 95% CI: 1.16, 2.94); (AOR: 3.00, 95% CI: 1.48, 6.08)], respectively. Conclusion: The study findings reveal that multiple unhealthy lifestyle behaviours, including insufficient physical activity, sedentary behaviour, inadequate fruit and vegetable consumption, frequent soft drink intake, and fast-food consumption, are globally prevalent among adolescents. These behaviours have distinct clustering patterns associated with individual characteristics, family and peer environments, and broader socio-economic and societal contexts. Full article

Background: The Middle East and North Africa (MENA) region is witnessing a continuous rise in the incidence of breast cancer (BC). This region is characterized by distinct cultural and lifestyle habits. Despite the importance of diet as a modifiable risk factor for BC, its role in the development of BC within the MENA context has not been extensively studied. This systematic review aims to identify and synthesize existing evidence regarding the effect of different dietary factors on BC risk among women from this region. Methods: We systematically reviewed the scientific literature for observational studies that examined the association between specific dietary factors and the risk of BC in MENA, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Our comprehensive search included databases such as PubMed, Web of Science, ScienceDirect, and Scopus, identified a total of 18,085 records, of which 65 met our inclusion criteria and were assessed for quality using the National Institute of Health Quality Assessment Tool. Results: The findings of the 65 included studies were categorized into food groups, nutrients, and dietary patterns. Studies in the MENA region have consistently shown that the consumption of fruit and vegetables, fish and seafood, and black tea are associated with a reduced BC risk. In contrast, the intake of milk and white bread is linked to an increased risk. Specific dietary patterns such as the Mediterranean diet, a healthy plant-based diet, dietary antioxidant index, and overall healthy dietary patterns have shown a negative association with BC risk. Conversely, the dietary insulin index and load, dietary glycemic index, dietary inflammatory index, and unhealthy dietary patterns are associated with an increased risk of BC. For the remaining dietary factors, research was too limited or inconsistent to draw conclusions. Conclusions: Our findings highlight the significant role of dietary factors in modulating BC risk among women in the MENA region, an area that faces a notable gap in research on this topic. Further studies are essential to deepen our understanding and develop targeted dietary recommendations for BC prevention in this population. Full article

The environmental impact of unhealthy diets and the obese population is becoming clearer. However, little is known about the impact of ‘healthy’ diets related to ‘fitness’ lifestyles, such as diets directed to gain muscle mass and lose body fat, or the diets of the physically active population. This paper aims to evaluate the Dietary Water Footprint (DWF) of a representative sample of the Guadalajara Metropolitan Area, Mexico, identifying differences according to body composition (levels of fat and muscle) and physical activity (type and intensity), with a focus on contrasting active, healthy lifestyles (i.e., fitness) with sedentary and obesogenic patterns and examining protein consumption. A validated and adapted Food Frequency Questionnaire (FFQ) was applied to 400 adults (18–74 years) from the Guadalajara Metropolitan Area. The participants were grouped according to their body fat and muscle mass levels and physical activity type and intensity. DWF, food and nutrient intake, and adequacy were calculated. The DWF of the sample with a low body fat, a high muscle mass, moderate to intense exercise, and anaerobic exercise (i.e., ‘fitness’ lifestyle) was up to 800 L per person per day (L/p/d) higher than the sedentary/obese populations. Risks of a high DWF were found as protein intake increases (OR = 6; p < 0.0001). Although unhealthy diets linked to obesity are a major environmental problem, ‘fitness’ lifestyles can have serious environmental implications. Full article

Background: The global rise in obesity has been significantly influenced by shifts in dietary habits that have been exacerbated by external factors such as the COVID-19 pandemic. This study aims to analyze the trends in Romanian dietary habits from 2015 to 2023, focusing on the impact of the COVID-19 pandemic and the role of socio-economic factors, seasonality, and cultural practices. Methods: For dietary habits, we used nationally representative data from the Romanian Household Budget Survey provided by the Romanian National Institute of Statistics. The survey includes 30,000 households annually. From the same provider, we downloaded data about potential drivers of food consumption, such as income, the consumer price index, and the unemployment rate. The analysis mixes descriptive statistics and panel data analysis. Among the main drivers, the econometric models include seasonality and regional factors, ensuring a comprehensive understanding of the changes in dietary behavior. Results: During the COVID-19 pandemic, daily calorie consumption increased to over 3000 calories per person, representing a 20% increase compared to the pre-pandemic period. Post-pandemic, food consumption remains elevated, averaging 2500–2600 calories per person daily. The pandemic also led to a shift in dietary composition, with significant changes. Thus, we mark an increase in fat (p < 0.001) and carbohydrate intake (p < 0.01) and a decrease in protein intake (p < 0.001). Beyond the presence of health disruptors, we confirm the significant impact of income (p < 0.001) and seasonality (p < 0.001). Other factors like unemployment, the consumer price index, and hidden regional factors have a minor role. Conclusions: The COVID-19 pandemic has had a lasting impact on Romanian dietary habits, reinforcing unhealthy eating patterns that were already prevalent. The sustained increase in calorie consumption, particularly of nutrient-poor, energy-dense foods, poses a significant public health challenge. The study also highlights significant seasonal variations, with a marked increase in food intake during the last quarter of the year, driven by cultural and religious traditions. These findings underscore the need for targeted public health interventions and policies that address economic factors and cultural and regional influences to promote healthier dietary behaviors in Romania. Full article