Search Results (761)

Vegan and vegetarian dietary patterns have moved from minority dietary choices to central elements of contemporary nutritional guidance, supported by observational cohorts, short-term randomised trials, and umbrella-level evidence (i.e., syntheses of multiple systematic reviews) reporting favourable associations with body weight, blood lipids, blood pressure, glycaemic control, and inflammatory markers. Recent direct comparisons against healthy omnivorous comparators—including the OMNIVEG controlled crossover transitioning from a traditional to a vegan Mediterranean diet and the Landry identical-twin trial—indicate that well-formulated plant-based patterns can produce additional short-term improvements in selected cardiometabolic markers even when the comparator is not the modern Western diet. Interpretation of the broader evidence base is nonetheless constrained by comparator quality, residual confounding, exposure misclassification, reliance on intermediate biomarkers, and limited follow-up. This critical narrative review integrates clinical, methodological, nutritional, and physiological evidence to compare vegan, vegetarian, and omnivorous dietary patterns, and argues that the dominant explanatory axis of long-term outcomes is dietary pattern quality—minimally processed plant-rich composition, nutrient adequacy, low ultra-processed food intake, and adherence—rather than the binary inclusion or exclusion of animal-source foods. Well-planned vegan and vegetarian patterns are valid dietary expressions that require systematic attention to vitamin B12, iodine, iron, zinc, calcium, vitamin D, EPA/DHA, and protein quality. Public health messaging should prioritise food quality, processing level, nutrient adequacy, adherence, and outcome hierarchy over binary dietary identities. Full article

Background: Sepsis-associated encephalopathy (SAE) is a serious complication affecting septic patients and significantly increases mortality. Serum 25-hydroxyvitamin D (vitamin D) deficiency is prevalent in critical illness, but its relationship with SAE prognosis remains unclear. Methods: This retrospective cohort study enrolled SAE patients at Nanjing Drum Tower Hospital (January 2023–June 2024). Vitamin D levels were measured within 24 h of ICU admission with insufficiency and deficiency defined as ≤30 ng/mL and ≤20 ng/mL, respectively. Demographics, severity scores, laboratory parameters, organ support, and 90-day mortality were collected. Statistical analyses included Mann–Whitney U/t-tests, Spearman’s correlation, multivariate logistic regression, and ROC analysis. Results: Among 346 sepsis patients, 47 met SAE criteria. Vitamin D insufficiency affected 97.9% (46/47) of SAE patients, with 85.1% (40/47) being deficient. Ninety-day mortality was 25.5% (12/47). Non-survivors had significantly lower vitamin D levels than survivors (median 10.15 vs. 12.83 ng/mL, p = 0.010). Multivariate analysis identified higher APACHE II score (OR 1.164, 95% CI 1.042–1.300; p = 0.007) and lower vitamin D level (OR 0.758, 95% CI 0.603–0.954; p = 0.018) as independent predictors of 90-day mortality. Combining APACHE II score and vitamin D provided excellent predictive value (AUC 0.886). Vitamin D levels correlated negatively with IL-6 (rho = −0.293, p = 0.045) and vasopressor use (rho = −0.410, p = 0.004). Conclusions: Vitamin D insufficiency is nearly universal in SAE patients. Lower admission vitamin D levels independently predict 90-day mortality and enhance the predictive power of APACHE II. Vitamin D levels were negatively correlated with IL-6, suggesting a potential relationship with inflammation, but causality and clinical significance require further investigation. Full article

Background and Objectives: Pediatric-onset metabolic bone diseases, including osteogenesis imperfecta (OI), hypophosphatemic rickets (XLH), hypoparathyroidism, and McCune–Albright syndrome (MAS), require lifelong follow-up because of persistent skeletal fragility, biochemical abnormalities, and functional morbidity extending into adulthood. However, evidence regarding structured transition from pediatric to adult care in these rare disorders remains limited. This study evaluated one-year outcomes of a multidisciplinary transition program for adolescents and young adults with rare metabolic bone diseases. Materials and Methods: This retrospective cohort study included 20 patients aged ≥17 years who underwent evaluation through a structured transition pathway consisting of multidisciplinary team meetings, a joint pediatric–adult transition clinic, and subsequent follow-up in adult endocrinology. Demographic, clinical, treatment, and transition-related data were extracted from medical records. The primary outcome was successful transition, defined as at least one adult endocrinology visit within 12 months. Secondary outcomes included attendance at the transition clinic, follow-up continuity, and treatment modifications. Results: All patients underwent multidisciplinary evaluation, and 85% attended the joint transition clinic. Successful transfer to adult endocrinology was achieved in 90% (18/20), while regular follow-up during the first year was maintained in 75%. Retention was highest in patients with OI, MAS, XLH, vitamin D-dependent rickets, and DiGeorge syndrome (100%). Greater variability was observed in postoperative and primary hypoparathyroidism. Treatment adjustments were required in 40% of patients, including optimization of phosphate/calcitriol replacement and reassessment of bisphosphonate or burosumab therapy. Three patients were lost to follow-up. No acute transition-related complications were observed. Conclusions: In this small exploratory cohort, implementation of a structured multidisciplinary transition pathway was feasible and was accompanied by high transfer and one-year retention rates. Observed differences across diagnostic subgroups should be interpreted cautiously, and larger multicenter comparative studies are needed to evaluate the effectiveness of structured transition frameworks. Full article

The prevalence of vitamin D deficiency has been noted to be of great concern to the population due to its association with multiple chronic ailments, such as those that affect the cardiovascular system, diabetes, bone diseases, and the immune system, and even some cancerous forms. The underlying mechanics are not well understood, but epidemiological and clinical research demonstrates notable correlations, correlated to different degrees by population, based on genetic, environmental, and lifestyle differences. The use of advanced machine learning methods in this study aimed to examine the association between serum vitamin D levels and chronic disease risk using the de-identified electronic health records from Intensive Care Unit (ICU) patients in the MIMIC-III database. A final cohort of 38,712 unique patients was selected after applying predefined inclusion and exclusion criteria, the data being used for machine learning model development and evaluation. To predict the status of chronic diseases based on vitamin D levels, supervised machine learning models were used: Logistic Regression (LR), Support Vector Machines (SVM), Random Forest (RF), and K-Nearest Neighbors (KNN). Data preprocessing involved strategies such as missing data imputation, normalization, and feature engineering to improve model training. The accuracy, precision, recall, F1-score, and receiver operating characteristic curve (ROC-AUC) were used to assess model performance. LR performed the best with the ROC-AUC of 92.5% and accuracy of 85.2%, and SVM was close behind the ROC-AUC: 90.9 percent. The chronic disease was associated with 2.1 times higher risk of chronic disease among people with severe vitamin D deficiency (p < 0.001), which was in agreement with earlier observational data. RF did not work as well (ROC-AUC: 87.7%) because it required higher dimensionality data, e.g., genetic and lifestyle parameters. The study shows the possible use of AI-based diagnostics in preventive medicine. As an example, presented vitamin D testing of high-risk population (e.g., increasing tests in old age, obesity, or dark-skinned population) adapted to ML-based risk assessment as well as supplementation plans could enhance this prevention. Full article

Background/Objectives: Interest in alternative, non-animal sources of vitamin D has increased due to the global prevalence of its deficiency and the growing demand for plant-based dietary options. Mushrooms and algae have emerged as potential sustainable sources of vitamin D₂ and, in selected cases, vitamin D₃ following ultraviolet (UV) exposure. However, the comparative bioavailability and clinical effectiveness of vitamin D₂ relative to vitamin D₃ remain controversial. This review aims to evaluate the content of vitamin D₂ in mushrooms and algae, the impact of UV irradiation on its synthesis, and the effectiveness of vitamin D₂ supplementation compared with vitamin D₃ in humans. Methods: PubMed, ScienceDirect, and Google Scholar were searched (1996–2026). Only human intervention studies were included when assessing clinical efficacy. Data on natural sources and pharmaceutical formulations were analyzed. Results: UV irradiation markedly increases vitamin D₂ content in mushrooms, as compared to cultivated products. Algal vitamin D content varies, depending on species and UV exposure, with no robust clinical trials confirming improvement of serum 25(OH)D after algal supplementation. Across multiple randomized controlled trials, vitamin D₂ consistently increased circulating 25(OH)D₂ but frequently reduced 25(OH)D₃ and demonstrated lower efficacy in raising total 25(OH)D compared with vitamin D₃, as confirmed by a recent meta-analysis. Conclusions: Although UV-enhanced mushrooms represent a quantifiable dietary source of vitamin D₂, clinical evidence consistently indicates lower efficacy of vitamin D₂ compared with vitamin D₃. Algae cannot currently be considered a validated source of vitamin D for improving human vitamin D status. Further mechanistic and long-term clinical studies are required. Full article

Background: Biomarkers are increasingly used in sport science and sports medicine to monitor training load, recovery, metabolic stress, nutritional status, and potential clinical risk in athletes. However, their interpretation is often limited by overreliance on isolated values, population reference ranges, and simplified thresholds. This narrative review aims to provide a contextual and metabolically informed framework for interpreting routine and emerging biomarkers in athletes. Methods: A critical narrative synthesis was conducted across key physiological domains relevant to athlete monitoring, including exercise intensity, metabolic flexibility, muscle damage, protein catabolism, hydration, hematological and iron status, micronutrient and bone–muscle health, inflammation, endocrine stress, sport-specific interpretation, and emerging metabolomics. The review integrated routine laboratory markers with pathway-level metabolomic interpretation and practical decision-making principles. Results: Routine markers such as lactate, creatine kinase, urea/blood urea nitrogen (BUN), creatinine, electrolytes, ferritin, C-reactive protein, cortisol, testosterone, and vitamin D are useful only when interpreted in relation to individual baseline, sampling conditions, recent workload, nutrition, hydration, sleep, illness, sex-specific physiology, and performance. Metabolomics expands interpretation by identifying pathway-level signatures involving glycolysis, β-oxidation, amino acid turnover, purine degradation, ketone bodies, acylcarnitines, bile acids, oxylipins, kynurenine metabolites, and exercise-induced signaling molecules such as lactate, β-aminoisobutyric acid (BAIBA), and N-lactoyl-phenylalanine (Lac-Phe). However, omics-derived markers require careful standardization and validation before routine applied use. Conclusions: Biomarkers should refine, not replace, clinical reasoning and athlete monitoring. A BASE framework (Baseline, Analytical standardization, Sport-specific context, and Evidence of functional change) may support more precise and proportionate interpretation of both routine blood tests and emerging metabolomic tools in athletes. Full article

Background: Osteoporotic vertebral compression fractures (OVCFs) are the most prevalent manifestation of osteoporotic skeletal disease, associated with severe pain, functional decline, and elevated risk of subsequent fractures. Conservative management remains the first-line approach for stable fractures, yet pain control is often suboptimal, and vertebral collapse progresses in up to 37% of patients. Bio-activated orthosilicic acid combined with vitamins D3 and K2 (BioSi-DK) may support fracture healing through complementary mechanisms acting on osteoblast differentiation, collagen synthesis, osteocalcin carboxylation, and mineralization, but its clinical efficacy in OVCFs has not previously been investigated. Methods: A retrospective, multi-center comparative cohort study was conducted in patients aged >50 years with DXA-confirmed osteoporosis and acute thoracolumbar OVCFs (AO Spine OF1-OF2) managed conservatively. Patients receiving BioSi-DK supplementation (two capsules daily for two months, then one capsule daily for four months) in addition to standard conservative treatment were compared with controls receiving conservative treatment alone. Propensity score matching (1:1, sex-exact constraint, caliper 0.3 SD) was applied across twelve pre-specified baseline covariates. The primary outcome was pain intensity at six months, assessed by numerical rating scale (NRS). Secondary outcomes included NRS change, analgesic use, Patient Global Impression of Change (PGIC), requirement for vertebral augmentation (kyphoplasty), MRI marrow edema score (MES), and Genant grade change. Results: After propensity score matching, 38 patients (19 per group) with balanced baseline characteristics were analyzed (mean age 71.2 ± 6.5 years; 89.5% female; mean T-score −2.61 ± 0.32; mean baseline NRS 8.26 ± 0.95). The BioSi-DK group achieved a significantly lower post-treatment NRS score compared with controls (2.05 ± 2.17 vs. 3.84 ± 2.83; p = 0.015; Cohen’s d = −0.71) and a significantly greater mean NRS reduction (−6.21 ± 1.90 vs. −4.42 ± 2.12 points; p = 0.005; d = −0.89). Analgesic discontinuation was more frequent in the BioSi-DK group (68.4% vs. 36.8%; p = 0.068). Kyphoplasty was required in 5.3% of BioSi-DK patients versus 21.1% of controls (p = 0.340; OR = 0.21), and vertebral compression grade remained stable in 100% of supplemented patients versus 84% of controls. At two months, MES improvement by at least one category was more frequently observed in the BioSi-DK group than in controls, suggesting an earlier edema resolution effect; at six months, MES distribution was comparable between groups (p = 0.620). Conclusions: BioSi-DK supplementation as an adjunct to conservative management was associated with a statistically significant and clinically large reduction in pain at six months, with favorable trends in analgesic burden, kyphoplasty requirement, and edema resolution. The safety profile was excellent. These findings support the conduct of prospective, randomized, placebo-controlled trials to confirm BioSi-DK as an effective adjunct therapy for OVCFs. Full article

Coeliac disease is a chronic autoimmune enteropathy triggered by gluten consumption in genetically predisposed individuals. Given that lifelong adherence to a gluten-free diet (GFD) is the only effective treatment, the nutritional quality of commercially available gluten-free (GF) products is of particular importance. The aim of this study was to determine the nutritional content of selected GF products across multiple food categories available in the Greek market and compare them with their gluten-containing (GC) counterparts. In addition, the nutritional adequacy of a GFD for adults was assessed through an indicative 7-day dietary meal plan. A total of 228 food products (114 GF and 114 GC), categorized as charcuterie, starchy, bakery, confectionery, miscellaneous, meat-based, and plant-based, were included. Analysis of food label information revealed broadly comparable nutritional profiles with respect to energy, fat, saturated fat, carbohydrate, sugar, and sodium between GF and GC products. However, GF products contained less protein (7.31 ± 4.94 g vs. 9.86 ± 4.79 g, p < 0.001) and more dietary fibre (4.55 ± 3.05 g vs. 3.23 ± 2.21 g, p = 0.001). Analysis of the meal plan demonstrated that recommended intakes for all evaluated macronutrients and most micronutrients can be achieved while following a GFD with careful dietary planning. However, iron intake fell slightly below the recommended level for premenopausal women, while meeting vitamin D requirements remained challenging. Full article

Background: Serum 25-hydroxyvitamin D [25(OH)D] interpretation requires clear distinction between epidemiological thresholds, routine-data distributions, and clinical decision limits. This study evaluated vitamin D status and clinically pre-filtered routine laboratory data-derived 25(OH)D distributional benchmarks among adults from Şanlıurfa, southeastern Türkiye, according to sex, age, and season. Methods: This retrospective single-center routine laboratory database study included adults aged 18–65 years tested between 1 January and 31 December 2025, at the Medical Biochemistry Laboratory of Şanlıurfa Mehmet Akif İnan Training and Research Hospital. After eligibility screening, duplicate removal, analytical screening, and predefined clinical pre-filtering, 48,826 participant-level records were analyzed. Serum 25(OH)D was measured using the Elecsys Vitamin D total III electrochemiluminescence immunoassay on a cobas e 801 analyzer/module. The primary distributional estimate was the nonparametric 2.5th–97.5th percentile range. Results: Median age was 38 [28–49] years, and 35,043 records were from female participants (71.8%). Median serum 25(OH)D was 12.74 [8.28–19.00] ng/mL. Vitamin D deficiency, severe deficiency, insufficiency, and sufficiency were observed in 38,072 (78.0%), 17,163 (35.2%), 8235 (16.9%), and 2519 (5.2%) records, respectively. Lower 25(OH)D concentrations and higher deficiency prevalence were observed among females, younger adults, and winter/spring samples, with small-to-modest effect magnitudes. The clinically pre-filtered routine-data 2.5th–97.5th percentile range was 3.46–35.50 ng/mL. Conclusions: Low 25(OH)D status was widespread among routinely tested adults in Şanlıurfa. The derived range should be interpreted only as a local routine-data distributional benchmark for the tested population, not as a healthy-volunteer reference interval, clinical sufficiency threshold, treatment threshold, or clinical decision limit. Full article

Background/Objectives: Foods and beverages consumed during school lunch periods contribute substantially to children’s dietary intake; however, Canadian evidence of their nutritional contribution and quality remains limited. This study assessed nutrient content, nutrient density, and contributions to dietary recommendations among Saskatchewan elementary students. Methods: A descriptive quantitative study was conducted among 379 students aged 5–13. Dietary intake during school lunch periods was assessed using a photography-assisted plate waste method. Nutrient content was estimated using standard nutrient databases, nutrient density was evaluated using the Nutrient-Rich Food (NRF) 9.3 Index, and contributions to dietary recommendations were examined. Results: Median lunch energy was 411.4 kcal (IQR: 296.7), and the mean NRF 9.3 score was 292.6 (SD: 130.7). Compared with home-packed and mixed lunches, school-provided lunches contained less energy, carbohydrate, fat, and sugar, while protein was similar across lunch types. Overall, lunches contributed <25% of daily requirements for key nutrients, including fibre, vitamin D, calcium, and potassium. Older students had lower proportional nutrient contributions relative to their higher nutritional requirements. Nutrient density differed by lunch provenance, but not by age or reported gender, with school-provided lunches achieving the highest NRF 9.3 scores. Conclusions: Lunches contributed modestly to daily nutrient requirements, particularly among older students. In this sample, school-provided lunches were associated with higher nutrient density than home-packed lunches, although their absolute contributions to several nutrients remained limited. These findings provide baseline evidence on lunches consumed during school lunch periods among Saskatchewan elementary students and may inform future evaluations of school food systems and policies. Full article

Age-related decline in immune system function is characterized by reduced numbers of naïve lymphocytes, the accumulation of senescent cells, impaired function of all immune cell types, and chronic low-grade inflammation (inflammaging). These alterations contribute to increased susceptibility to infections and malignancies, as well as to autoimmunity and other age-associated diseases. This article reviews current evidence on lifestyle interventions that may mitigate immune aging. Lifestyle-related strategies, including regular physical activity, nutritional interventions (e.g., different diets, caloric restriction, and other fasting-related approaches), stress reduction, and vaccination, are discussed as key modulators of immune function and systemic inflammation. Notably, vitamin D supplementation has been shown to reduce the incidence of autoimmune diseases by 22%. In comparison, caloric restriction has led to a decrease in CRP and TNF-α by 40% and 50%, respectively. Emerging complementary approaches, such as mind–body practices and controlled cold exposure, show promise, though current evidence remains limited and inconsistent. Therefore, integrated lifestyle strategies may slow aging-related immune decline and support healthy aging. However, longitudinal trials are required to define the optimal intervention parameters, population-specific thresholds, and the long-term durability of immune rejuvenation. Full article

Background/Objectives: Vitamin D, universally recognized for its role in calcium–phosphate homeostasis and skeletal health, has emerged as a key immuno-endocrine modulator. Its active metabolite interacts with the vitamin D receptor (VDR) across immune and endocrine cell populations, influencing gene transcription, cytokine balance, and immune tolerance. This narrative review synthesizes mechanistic, epidemiological, and clinical evidence on the role of vitamin D in immune modulation across autoimmune and infectious diseases. Methods: This narrative review incorporated a structured and comprehensive literature search across PubMed/MEDLINE, Scopus, Web of Science, Embase, and Google Scholar. Results: Vitamin D modulates both innate and adaptive immunity through antimicrobial peptide induction, macrophage and NK cell activation, and promotion of tolerogenic dendritic cells. Clinical and interventional trial outcomes remain heterogeneous and are influenced by baseline vitamin D status, dosing regimens, genetic variability, and disease context. Conclusions: Vitamin D functions in endocrine and immune regulation, contributing to host defense and immune tolerance. Current evidence supports that for autoimmune and infectious conditions, well-designed randomized trials are required to clarify effective dosing, identify responsive subpopulations, and elucidate genetic determinants of therapeutic benefit. Full article

Background/Objectives: Although current research suggests beneficial effects of dietary supplements on female infertility, existing evidence is often inconsistent and of limited certainty. This systematic review and meta-analysis aimed to investigate the effect of dietary supplements on female infertility in terms of endometrial thickness, pregnancy, live birth, and miscarriage compared to placebo (primary objective) and compared to placebo or a no-treatment comparator (secondary objective). Methods: PubMed, Embase, and CENTRAL were searched up to March 2025. Randomized controlled trials assessing the effect of dietary supplements compared to placebo or a no-treatment comparator among infertile women were included. Screening, data extraction, risk of bias, and certainty of evidence assessments were conducted by two independent reviewers. Data was synthesized quantitatively using random effects restricted maximum likelihood models. Results: Twenty placebo-controlled and 20 no-treatment comparator studies were included. Most studies had some concerns in risk of bias. Primary analyses showed an improvement in endometrial thickness following N-acetyl-cysteine supplementation compared to placebo, while no effect was found for supplements on pregnancy-related outcomes. Certainty of evidence of primary analyses was low. Secondary analyses indicated positive differences in endometrial thickness and pregnancy-related outcomes following supplementation with different supplements compared to placebo and no treatment. Conclusions: This review found no high-certainty evidence that dietary supplements improve female infertility outcomes when compared with placebo. Secondary analyses combining placebo and no-treatment comparator studies generated hypotheses for myo-inositol, N-acetyl-cysteine, vitamin D, vitamin E, and ≥3 substance dietary supplements, but these are at higher risk of bias and require confirmation in adequately powered placebo-controlled trials with live birth as the primary outcome. Full article

Background: Acute kidney injury (AKI) is a frequent and prognostically important complication of cardiac surgery, yet early risk stratification remains challenging. The purpose of this prospective exploratory study was to determine whether preoperative vitamin levels differ in patients who develop cardiac surgery-associated AKI. Methods: Consecutive patients scheduled for cardiac surgery due to coronary artery disease and/or severe aortic stenosis between October 2024 and July 2025 were included. Fourteen patients (16.1%) had preoperative eGFR below 60 mL/min. Preoperative serum levels of vitamin A (retinol), vitamin E (α-tocopherol), and vitamin D (25-hydroxyvitamin D3) were measured. Results: A total of 87 patients (72 males (82.8%) with a median (Q1–Q3) age of 66 (61.5–71) years) were included in the study. Cardiac surgery-associated AKI occurred in 36 (41.4%), as a mild and transient impairment, with only two patients with a more severe stage requiring temporary renal replacement therapy. Patients who developed AKI had significantly higher preoperative retinol levels (p = 0.046). Retinol concentrations correlated positively with preoperative creatinine (Spearman’s rho 0.321, p = 0.002), postoperative day 0 creatinine (Spearman’s rho 0.333, p = 0.002), and postoperative day 1 creatinine (Spearman’s rho 0.268, p = 0.012), and negatively with preoperative eGFR (Spearman’s rho −0.288, p = 0.007). Tocopherol and 25(OH)D3 did not differ significantly between subgroups. No difference in vitamin levels was observed between patients with and without diabetes. Conclusions: Increased preoperative retinol levels were associated with cardiac surgery-associated AKI and correlated with perioperative renal dysfunction. Retinol may reflect impaired kidney handling of retinol and identify increased renal vulnerability in cardiac surgery patients. Retinol may represent a hypothesis-generating biomarker of cardiac surgery-associated AKI risk that warrants confirmation in larger cohorts. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with obesity, insulin resistance, and altered body composition. Although dietary intervention is a cornerstone of treatment, complex or calorie-restricted regimens may reduce long-term adherence. This study evaluated the effects of a pragmatic, short-term intervention that involved replacing one daily carbohydrate serving with cruciferous vegetables on body composition and metabolic parameters in individuals with obesity and MASLD. Associations between changes in fat mass and vitamin D and follistatin levels were also explored. Methods: In this prospective pilot study, 44 adults with obesity and MASLD followed a two-month intervention, substituting one daily serving of carbohydrate-rich foods with 200 g of cruciferous vegetables, without prescribed caloric restriction. Anthropometric, bioimpedance, biochemical, and FibroScan assessments were performed at baseline and post-intervention. Changes were analyzed using the Wilcoxon signed-rank test, Spearman’s correlation analysis, and generalized estimating equation (GEE) models adjusted for confounding factors. Results: The intervention was associated with a significant reduction in fat mass (−4.86 kg, p < 0.001), corresponding to an average relative decrease of approximately 12% along with improvements in metabolic and hepatic parameters. Changes in fat mass were inversely correlated with changes in vitamin D (rho = −0.33, p = 0.035), fat-free mass (rho = −0.37, p = 0.018), and follistatin (rho = −0.24, p = 0.143). In multivariate GEE models, the intervention remained independently associated with fat mass reduction (β = −5.190, p < 0.001). Conclusions: A simple carbohydrate-to-vegetable substitution without prescribed caloric restriction was associated with improvements in body composition and metabolic health. These exploratory findings suggest that pragmatic dietary modifications may provide clinically meaningful metabolic benefits and support the feasibility of minimal dietary substitution strategies in this population. However, causal inferences remain limited by a single-arm pilot design and require confirmation in larger randomized controlled trials. Full article