Search Results (693)

The aim of this study was to assess bone health in individuals over 60 years of age in Kazakhstan, focusing on the relationship between osteoporosis, body mass index (BMI), body composition, and nutritional factors. This study included 1961 participants, consisting of 1620 women and 341 men, aged 60 to 89. Bone strength was assessed using quantitative ultrasound of the calcaneus, while fracture risk was assessed with the FRAX tool. Osteoporosis was detected in 20.2% of women and 15.2% of men, and osteopenia affected 59.8% of women and 58.4% of men. A total of 73.7% of the participants were overweight, 38.2% were pre-obese, and 35.5% were obese. The results of the study emphasise that, in addition to classic nutrients (calcium, vitamin D, protein), a number of trace elements and vitamins (selenium, iodine, zinc, vitamin B6, phytosterols) also play a significant, possibly indirect, role in bone metabolism. An inverse correlation was observed between BMI and osteoporosis prevalence; with a decrease in BMI, the incidence of osteoporosis increased (women: χ² = 26.0, df = 2, p < 0.001; men: χ² = 4.29, df = 2, p < 0.014; total sample: χ² = 32.3, df = 2, p < 0.001), thus confirming that excess body fat exerts a protective effect on bone health. Significant risk factors for osteoporosis included age, height, and weight. A link was found between the age of first osteoporosis onset and BMI (from 65 to 72.14 years). This confirms the value of FRAX for accurately assessing fracture risk and developing personalised recommendations based on anthropometric and dietary characteristics. Future longitudinal research is warranted to validate these results and further elucidate the underlying mechanisms, including the predictive power of novel anthropometric parameters such as the Body Roundness Index and Body Shape Index. 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/Objectives: To critically evaluate the current scientific literature on the physiological and preventive functions of vitamin D, with special emphasis on its possible involvement in multi-organ pathologies, and to assess the effectiveness of supplementation strategies for maintaining homeostasis. Methods: A review of the literature was conducted following a methodological approach in accordance with the PRISMA 2020 statement for systematic reviews. The bibliographic search was carried out in the PubMed, Scopus, and Web of Science databases, using controlled terms and Boolean operators. Rigorous inclusion and exclusion criteria were applied in three phases: blind search, selection by title/abstract, and full-text evaluation. Articles published in first quartile journals (JCR 2023) were prioritized. The search was complemented with targeted strategies such as consulting ORCID profiles, using the Jábega tool, and tracking cross-references. Results: The selected studies reinforce that vitamin D acts as a transcriptional modulator with effects beyond the skeletal system, including immunomodulatory, neuroprotective, and antitumor functions. Associations were identified between low levels of 25(OH)D and a higher prevalence of autoimmune, neurodegenerative, and metabolic diseases, as well as certain types of cancer. However, evidence of causality is still limited, and clinical trials have shown mixed results regarding its preventive efficacy. Supplementation strategies are useful in vulnerable populations, although their indiscriminate use without a documented deficiency is not recommended. Conclusions: Vitamin D is emerging as a potentially relevant agent in preventive medicine. While its benefits extrapolated from bone metabolism still require robust clinical validation, current findings support its role in regulating key systemic functions. A balanced approach combining sun protection, health education, food fortification, and targeted supplementation, tailored to the clinical context of each individual, is recommended. Full article

Introduction: Vitamin D is involved in numerous processes and is obtained both exogenously and endogenously. Its active form is 1,25-dihydroxycholecalciferol, which exerts its biological effects via the vitamin D receptor (VDR). The main factors influencing VDR density are polymorphisms of the VDR gene, which may affect, e.g., gene mRNA stability and also VDR gene expression. There are four main polymorphic sites within the gene, BsmI, ApaI, FokI and TaqI, and two polymorphisms related to the gene promoter: GATA and Cdx2. One of the functions of vitamin D is to modulate the immune system. It affects T lymphocytes, B lymphocytes and dendritic cells. Currently, vitamin D deficiency is a common global problem that is associated with an increased risk of autoimmune diseases, including Hashimoto’s thyroiditis. Numerous studies have demonstrated an association between low vitamin D levels and elevated thyroid-stimulating hormone (TSH) levels, and have also proven the existence of a negative correlation between vitamin D levels andanti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibody titers. Review objectives and a concise summary of the methodology: The review aims to analyze studies examining the relationship between specific VDR polymorphisms, vitamin D levels, and the development of various diseases, with a particular emphasis on Hashimoto’s thyroiditis. This review is based on original and review articles written in English published between March 2018–November 2024 searched primarily in the PubMed, and additionally in Google Scholar databases. A narrative review of the literature was conducted. Conclusions: The presence of specific VDR polymorphisms influences the effectiveness of vitamin D supplementation, but the role of supplementation in the prevention of autoimmune diseases has not been definitively confirmed. To date, studies have primarily involved relatively small groups of patients with significant population heterogeneity, with case–control investigations being the most common. Therefore, further research on larger, more homogeneous groups is recommended to achieve more standardized results. Additionally, the influence of epigenetic factors modulating VDR activity and its interactions with the environmental factors is also important. Full article

Background/Objectives: Dietary intake during pregnancy influences hematological parameters, reflecting nutritional status and potentially affecting maternal and fetal outcomes. This cross-sectional pilot study aimed to compare dietary nutrient intake in pregnant women depending on their red cell distribution width-coefficient of variation (RDW-CV). Methods: A total of 31 pregnant women in their third trimester were divided into the following two groups: within reference range RDW-CV (n = 22) and elevated RDW-CV (n = 9). Dietary intake was assessed via a dietary recall (USDA Multiple-Pass Method). Intake of energy (kcal/day), macronutrients (g/day), vitamins (mg/day; µg/day) B1, B3, B6, B9, B12, C, A, D, E, and minerals (mg/day) Zn, P, Mg, K, Ca, Fe were recorded. Complete blood count (CBC) parameters were measured (Total WBC, HGB, HCT, MCV, RDW-CV, PLT, NEU, LYM, MON, EOS, BAS, LMR). Results: The elevated RDW-CV group had a significantly lower level of daily energy adequacy. Both groups did not meet recommended intakes for energy, iron, vitamin D. A statistical significance in MCV differences was noted, with lower values in the elevated RDW-CV group, supported by a Cohen’s d = 0.82, suggesting early changes in erythrocyte size distribution. The reference range RDW-CV group consumed significantly more zinc, phosphorus, calcium, and vitamin B12, whereas vitamin C intake was higher in the elevated RDW-CV group. Conclusions: Pregnant women with an elevated RDW-CV tended to exhibit greater nutritional insufficiencies than those with reference range RDW-CV. Our findings suggest potential associations between hematologic indices (RDW-CV, MCV) and dietary nutrient intake patterns during pregnancy. These preliminary observations are based on a pilot study and warrant confirmation in larger, prospective studies incorporating biochemical markers. Full article

Biathlon is a winter Olympic sport that combines high-intensity cross-country skiing with precise rifle shooting. These dual demands require athletes to develop exceptional aerobic capacity while maintaining fine motor accuracy under physiological stress. Despite its complexity, nutritional strategies in biathlon remain under-explored and recommendations are often extrapolated from related endurance sports. This narrative review aims to summarise existing knowledge on nutrition in biathlon, highlight sport-specific challenges and identify areas for future research. The main findings indicate that biathletes face very high energy demands, with daily expenditure exceeding 7000 kcal during intensive training. Carbohydrates are the primary fuel source, with intake recommendations based on training intensity and duration (6–12 g/kg/d). Furthermore, protein is essential for muscle repair, recovery and adaptation. To achieve the recommended intake of 1.6 g/kg/day, it is advisable to consume meals containing approximately 0.3 g/kg of high-quality protein every three to four hours. Given the frequency of training sessions, effective recovery strategies are important in biathlon. When recovery is a priority, biathletes should consume a meal comprising protein (approximately 0.3 g/kg) and carbohydrates (approximately 1.2 g/kg) before key training sessions. Micronutrient and vitamin deficiencies are not commonly observed in biathletes due to their high calorie intake. However, concerns regarding iron and vitamin D are common among endurance athletes due to the high risk of low energy intake, diets lacking in iron, and insufficient exposure to sunlight. On the day of the race, it is recommended that biathletes plan their meals to ensure that they meet their nutritional needs and begin recovery as soon as possible after the race is over. Biathletes may use specific supplements to enhance performance and health during preparation and competition. However, it is important to note that some supplements that improve performance may harm shooting accuracy. Current guidance is provisional, and future research should adopt a dual-performance framework that evaluates both endurance output and shooting precision under realistic competition conditions. Full article

Background/Objectives: The past evidence indicates that Polish children’s diets frequently deviate from recommendations. The aim of the PITNUTS 2024 study was to provide an updated nationwide assessment of energy and nutrient intake among children aged 5–72 months, evaluate the risk of inadequate intake, and examine the relationship between diet quality patterns and nutritional adequacy. Methods: PITNUTS 2024 was a cross-sectional study analyzing dietary data from a representative sample of 940 Polish children. Dietary intake was assessed qualitatively and quantitatively. Nutrient adequacy was evaluated using the estimated average requirement or adequate intake cut-point method. Two diet quality scores were developed: the Children’s pro-Healthy Diet Score and the Children’s non-Healthy Diet Score, and their association with the risk of inadequate intake was evaluated using logistic regression. Results: The proportion of energy derived from protein intake exceeded recommended levels in most children, while that from fat was typically below reference levels, especially in younger groups of children. The risk of inadequate energy intake from carbohydrates was uncommon, while sucrose intake exceeding 10% of overall energy was present in almost half of the children. Among children aged 13–72 months, approximately 15% adhered to high child-pHDS, associated with a lower risk of insufficient intake of selected nutrients. Conclusions: The diets of Polish children aged 5–72 months show persistent nutritional risks, including excessive protein intake, low vitamin D intake, suboptimal fatty acid intake profiles, and insufficient calcium and fibre intake. Diet quality scores can be useful for identifying children at risk of inadequate nutrient intake. Full article

Background: Vitamin D is essential for women’s health, yet deficiency is widespread among Moroccan premenopausal women. Objectives: This study examined vitamin D intake, dietary sources, determinants, and predictors of serum 25-hydroxyvitamin D [25(OH)D₃] in 355 women aged 18–49 years in Meknes, Morocco. Methods: Intake and sun exposure were assessed with validated questionnaires, and serum 25(OH)D₃ was measured by chemiluminescence immunoassay. Multivariable and penalized regression (LASSO) were applied to deseasonalized values. Results: Median intake was 2.89 µg/day, and fewer than 20% of participants met the 5 µg/day recommendation. Fish (48%), dairy (24.39%), and meat (9.40%) were the main sources. Intake varied by age and residence: women aged 18–25 had significantly lower intakes (p = 0.027), while rural women consumed less than urban women (2.73 vs. 3.18 µg/day, p = 0.014), with inadequacy in 67.70% vs. 32.30% (p = 0.018). In adjusted regression, quartiles Q2–Q4 (1.76–16.60 µg/day) were associated with ~+3 ng/mL higher serum 25(OH)D compared to Q1 (0.20–1.76 µg/day, p < 0.05). Increments plateaued beyond Q2, and deficiency (<20 ng/mL) persisted in all quartiles (>59%, including 64% in Q4), reflecting limited sun exposure and high adiposity. Sun exposure was a strong positive predictor (β = 0.35, p < 0.001), while BMI was inversely associated (β = −0.37, p < 0.001). In LASSO, only sun exposure remained, explaining ~3% of variance. Conclusion: In this population, improving sun exposure (≥20 min/day) should be prioritized, alongside increasing vitamin D intake through richer food sources and fortification, while also addressing obesity, with a focus on women at risk of deficiency. Full article

Background: Vitamin D deficiency (VDD) is highly prevalent in pediatric critically ill patients and is a potentially modifiable risk factor during critical illness. There are no established national or international recommendations for vitamin D supplementation in Pediatric Intensive Care Unit (PICU) patients. Objectives: This monocentric study aims to compare the practices regarding vitamin D supplementation before and after the introduction of a nutrition protocol (NP). Methods: We retrospectively analyzed vitamin D administration (time from PICU admission to initiation, amount of supplementation, accordance with existing guidelines) in children aged 0 to 16 who were admitted to the PICU of Lausanne University Hospital for more than 48 h the year before and the year after the introduction of a NP. Results: Vitamin D supplementation increased after NP introduction (95 IU per day more, p < 0.0001). More patients received vitamin D during their stay (95% after vs. 77% before, p < 0.0001). The dose adhered to NP recommendations for children under 12 and was higher for older children. According to Swiss guidelines for the general pediatric population, vitamin D supplementation was accurate in children under one year old before and after NP implementation. However, it was less than recommended for patients over one year old. Conclusions: The implementation of a NP significantly enhanced the scope of vitamin D supplementation. This study also highlights the practical limitations in meeting the recommended requirements with certain galenic formulations. Full article

Introduction: This study evaluates the efficacy of a nurse practitioner-managed, computer algorithm-supported institutional fracture liaison service (FLS) that provides treatment recommendations for patients with hip fractures. Methods: A retrospective study included patients hospitalized in the Orthopedic ward with hip fractures between April 1 and October 31. The decision-making algorithm recommends zoledronic acid as the default medication, except for patients younger than 65 years, with estimated glomerular filtration rate (eGFR) <35 or prior osteoporosis therapy, who are ordered to undergo endocrinology consultation. Patients with vitamin D deficiency/insufficiency are given a loading dose. Results: Two hundred and eight hip fracture patients were identified. The cohort was predominantly female (137/208, 65.9%); the mean age was 79.9 ± 9.6 years. Nurse practitioner evaluation was performed in 200/208 patients (96.2%). The algorithm provided a treatment recommendation in 140 out of 200 (70.0%), while 60 out of 200 (30.0%) required an endocrinology consultation. A Vitamin D loading dose was given in 89/99 (89.9%) deficiency and 44/62 (71.0%) insufficiency cases. Conclusions: This simplified algorithm-based FLS model demonstrated practicality and feasibility in providing therapeutic recommendations with minimal physician intervention. Full article

The problems of excessive nitrogen fertilizer application and mismatch between varieties and planting density are common in potato production in the dryland farming areas of Loess Plateau, and it is of great significance to select suitable nitrogen application rates and planting densities for the green and sustainable production of dryland potatoes in this area. In this study, Longshu 16 was selected as the potato variety, and we investigated two nitrogen application rates: 200 kg·hm⁻² (N1), 300 kg·hm⁻² (N2); and three planting densities: 37,500 plants·hm⁻² (D1), 52,500 plants·hm⁻² (D2), 67,500 plants·hm⁻² (D3). The effects of different nitrogen fertilization rates and planting densities on photosynthetic characteristics, leaf carbon and nitrogen metabolism enzyme activities, and yield and quality of potato were measured and analyzed. The results showed that during the tuber swelling stage, the activity of ribose-1,5-diphosphate carboxylase oxygenase (Rubisco) in potato leaves was increased by 9.05%. During the starch accumulation stage, the activity of glutamine synthetase (GS) in potato leaves was increased by 3.02~22.34% in N1D2 treatment compared with other treatments, and the activity of glutamate synthase (GOGAT) was increased by 2.83~7.35% compared with other treatments. During the starch accumulation stage, the activity of ADP-glucose pyrophosphorylase (AGPase) in potato leaves was increased by 7.85~31.17% in N1D2 treatment compared with other treatments. The contents of protein, starch, vitamin C, and calcium in potato tubers in N1D2 treatment were the highest, and the yield was the highest in N1D2 treatment. In conclusion, the recommended nitrogen application rate of 200 kg·hm⁻² and planting density of 52,500 plants·hm⁻² in dry-fed potato production improved the yield and quality of potato by enhancing activities of GAPDH, GS, and AGPase. Full article

Objectives: The rapid aging of the U.S. population has raised concerns about age-related cognitive decline and Alzheimer’s disease. Therefore, we aimed to characterize diet quality, nutrient intake, and to examine the associations between specific dietary components and cognitive performance in older adults. Design: Cross-sectional observational study. Setting: Community-based recruitment. Participants: Data from 72 community-dwelling adults aged 65 years and older was analyzed. Measurements: Cognitive performance was assessed using subtests from the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) battery, evaluating episodic memory (Word List Memory/Recall/Recognition), visuospatial skills (Constructional Praxis), and executive function (Verbal Fluency). A composite cognitive score was calculated from memory and visuospatial subtests. Habitual dietary intake was evaluated using structured 24-h recalls to calculate nutrient intake and the Healthy Eating Index score, supplemented by the Short HEI questionnaire. Demographics, health history, depressive symptoms (Patient Health Questionnaire-9), and sleep quality (Pittsburgh Sleep Quality Index) were also collected. Results: Participants demonstrated suboptimal diet quality (mean HEI score 62.9 ± 10.69; recommended >80), with only 9.7% meeting fiber recommendations, 11% meeting calcium or vitamin A recommendations, and 1.4% meeting vitamin D requirements. In bivariate comparisons, higher cognitive performance was observed in younger participants (75.5 vs. 79.5 years; p < 0.01) and females (78% vs. 50%; p = 0.024). Regression models identified significant positive associations between cognitive scores and intakes of dietary fiber (p = 0.007), unsaturated fats (mono- and polyunsaturated; p = 0.012–0.033), protein (p = 0.018), carotenoids (α-carotene, p = 0.001; β-carotene, p = 0.026; lutein + zeaxanthin, p = 0.016), vitamins A (p = 0.044) and E (p = 0.034), and minerals including magnesium (p = 0.006), potassium (p = 0.004), copper (p = 0.008), zinc (p = 0.024), and calcium (p = 0.035). Refined grain intake was inversely associated with cognition (p = 0.011). Conclusions: In this population, dietary components like fiber and micronutrients were positively associated with better cognitive function, and the overall nutrient intake shortfalls observed highlight the need for targeted dietary interventions to support healthy brain aging. Therefore, this work advances our understanding by highlighting potential modifiable nutritional targets for clinical trials focused on delaying or preventing cognitive decline. Full article

Depression is a prevalent and disabling psychiatric disorder, characterized by persistent disturbances in mood, cognition, and physiological processes, which collectively lead to substantial impairments in daily functioning and quality of life. This review provides a comprehensive overview of the biological mechanisms implicated in the pathophysiology of depression, including neurotransmitter dysregulation, oxidative stress, inflammatory processes, hypothalamic-pituitary-adrenal (HPA) axis dysfunction, mitochondrial impairment, and alterations in the gut-brain axis. Furthermore, it explores the role of diet in both the prevention and management of depression, with particular emphasis on Mediterranean, anti-inflammatory, and ketogenic dietary patterns, while contrasting these with the detrimental impact of a Western dietary pattern. Specific nutrients-such as n-3 polyunsaturated fatty acids (PUFAs), B-complex vitamins, vitamins D and E, zinc, selenium, and polyphenols-are highlighted for their potential roles in modulating neurotransmission, attenuating inflammation, and supporting gut microbiota homeostasis. Despite growing scientific interest in nutrition-based interventions, current evidence on the comparative efficacy of different dietary approaches remains limited. Future research is warranted to elucidate the therapeutic potential of dietary strategies as adjuncts to conventional treatments for depression and to facilitate the development of evidence-based nutritional recommendations for clinical practice. Full article

Exercise and bone health are crucial for overall cardiovascular and metabolic well-being. However, certain types of activities can increase the risk of osteoporotic fractures. Preventing injuries while remaining active can be challenging, particularly for older competitive recreational athletes whose training volumes can be comparable to those of professional athletes. While high levels of physical activity in older adults typically lead to thicker cortical bone and improved physical fitness, age-related bone loss, hormonal changes, nutrition, and a history of fractures can significantly raise the risk of osteoporosis. This narrative review provides a descriptive summary of the current understanding of the paradox between exercise and bone fragility, particularly in recreational athletes. Many older athletes may be unaware of their declining bone mineral density, believing that their activity levels are sufficient. Ironically, high-impact activities like running and jumping, which are generally recommended for the prevention of osteoporosis, can also increase the risk of stress fractures. Early detection of osteoporosis is crucial, and this can be achieved through DEXA scans and regular bone density tests, allowing for timely intervention before fractures occur. Alongside medications, strength training, as well as balance and stability exercises, can be very beneficial. It is also important to maintain healthy lifestyle choices, ensure adequate energy levels, and consume sufficient amounts of calcium and vitamin D. Furthermore, monitoring training volume and allowing for proper recovery can help reduce the risk of osteoporotic stress fractures in athletes. Full article