This review examines the physical foundations, predictive models, emerging technologies and recent research trends in bioimpedance for clinical nutrition. A bibliometric analysis of cumulative scientific production from 1980 to 2025 shows that weighted logistic models provide a good descriptive fit to the evolution of the literature (R2 ≥ 0.999). Bioimpedance research remains in an expanding phase, with its projected inflection point lying beyond 2026. These fits are descriptive and model-dependent: high coefficients of determination on cumulative counts are not in themselves evidence of predictive validity, and inflection points beyond the observation window are extrapolations. We introduce the Measurement-Independent Factor (MIF), which isolates the anthropometric contribution from the bioimpedance measurement in predictive equations. Phase Angle (PhA) has emerged as the most extensively studied bioimpedance descriptor, since it avoids the population-specific prediction equations required for estimates such as FFM or FM, although its absolute value remains dependent on measurement conditions, instrumentation and biological characteristics. Body-composition estimates obtained with devices from different manufacturers should not be interpreted interchangeably. Electrode technologies, bioimpedance wearables, and bioimpedance imaging are reviewed as major emerging research directions. A second bibliometric analysis covering the most-cited literature from 2020 to 2026 and 1655 original articles published during 2025–2026 show that recent research focuses primarily on obesity and adiposity, together with sarcopenia and frailty, whereas critical and acute care remain underrepresented.
Background/Objectives: This study characterized compositional variation among 996 foods and beverages retained from the Universidad San Francisco de Quito Food Chemical Composition Table after record-level quality control. Methods: Nineteen nutritional variables were evaluated using descriptive statistics, heteroscedastic one-way analysis of variance, rank correlations, principal component analysis, and hierarchical clustering. Missingness was substantial and non-random across food groups; 427 records contained all 19 variables and were used for multivariate analyses. Results: Welch tests with Holm correction identified food-group differences for all variables, although the magnitude of group separation ranged from small for vitamin A (η2 = 0.029, 95% CI 0.016–0.061) to large for carbohydrates (η2 = 0.590, 95% CI 0.555–0.632) and energy (η2 = 0.588, 95% CI 0.530–0.654). Spearman analysis showed strong expected compositional associations between total fat and monounsaturated fatty acids (ρ = 0.956) and between total fat and saturated fatty acids (ρ = 0.937), together with non-arithmetic associations involving protein, phosphorus, zinc, cholesterol, and vitamin B12. Parallel analysis retained four principal components, which explained 61.4% of total variance; the first two accounted for 40.2% and primarily represented energy-lipid-mineral covariation and lipid composition. Ward clustering in the full 19-dimensional standardized space supported a three-cluster solution (silhouette = 0.482; median subsampling adjusted Rand index = 0.845), comprising a broad mixed profile, a fiber- and mineral-dense profile, and an oil-dominant profile. Conclusions: These results describe compositional patterns within the USFQ database and provide a reproducible basis for database harmonization, nutrient profiling, and hypothesis generation. They do not estimate dietary intake, food availability, nutritional adequacy, or health outcomes in the Ecuadorian population.
Taste contributes to food selection by integrating sensory information with physiological state and prior experience. Sodium is essential, continually lost, and homeostatically regulated, yet it is abundant and frequently overconsumed in contemporary food environments. This conceptual narrative review proposes the Sodium Priority Hypothesis, as follows: sodium may function as a nutritional target whose acquisition and food acceptance are supported by several partly independent sensory routes. Sodium chloride provides the dominant dietary route to saltiness, although the molecular basis of human salt taste remains unresolved and may involve both sodium- and chloride-dependent mechanisms. Sodium salts can also suppress bitterness and modify taste mixtures in concentration- and matrix-dependent ways. A further, more speculative proposition is that sodium-bearing umami stimuli may have behavioural relevance beyond glutamate-derived umami quality. The framework is intended to connect two timescales: the physiological and evolutionary pressures that promoted sodium acquisition when availability was variable, and the contemporary food environment, in which abundant, inexpensive sodium is widely used to enhance food palatability. It does not claim that sodium alone explains modern excess intake, that prehistoric populations routinely added salt, or that sodium is required for activation of umami receptors. Evidence is strongest for sodium physiology, sodium appetite, salt taste, and selected mixture effects; direct evidence for a sodium-specific contribution to umami liking or intake remains limited. The hypothesis is therefore an organising and falsifiable framework that requires experimental validation. It is explanatory rather than prescriptive.
Background: Malnutrition and metabolic dysregulation are common in motor neuron disease (MND) and contribute to accelerated functional decline and reduced survival. Routine serum biochemical analytes can be used to assess nutritional status; however, their interpretation in MND is confounded by systemic inflammation and disease-related metabolic changes. This study investigated the relationship between serum biochemical analytes, inflammatory status, disease severity, progression, and body composition in people living with MND. Methods: In this single-centre, longitudinal prospective cohort study, 19 participants with confirmed MND were assessed at enrolment and at three-month intervals up to nine months. Serum concentrations of albumin, prealbumin, creatinine, transferrin, ferritin, retinol-binding protein, and lipid fractions were measured alongside routine inflammatory markers. Disease severity and progression were assessed using the revised ALS functional rating scale and King’s College Staging System. Anthropometry included percentage weight change, body mass index, mid-upper arm circumference, triceps skinfold thickness, arm muscle area, and calf circumference. Participants with evidence of baseline inflammation were excluded from nutritional analyses. Results: Low-grade systemic inflammation was present in 9/19 (47%) of participants at enrolment, most commonly reflected by elevated fibrinogen. In the non-inflammatory sub-cohort (n/N = 10/19), serum creatinine was positively correlated with muscle-related functional subscores (p = 0.007) and declined between enrolment and three months (p = 0.02), showing predominantly negative trajectories by nine months. HDL cholesterol also declined over the nine-month follow-up (p = 0.03) and lipid fractions correlated positively with disease stage (p <0.001–0.02), suggesting evolving metabolic stress. Elevated serum retinol-binding protein was observed in 90% (n/N = 9/10) of participants without inflammation. Biochemical evidence of malnutrition (low transferrin and/or creatinine) was detected in one-third of participants, accompanied by weight loss and reductions in limb anthropometric parameters. Malnutrition risk was identified in 1/10 (10%) of the non-inflammatory sub-cohort using a modified ESPEN-based framework, and in 2/10 (20%) participants using GLIM criteria. Conclusions: Routine serum biochemical analytes provide complementary information on nutritional and metabolic status in MND when interpreted alongside inflammatory markers and anthropometry. Serum creatinine emerged as a longitudinal marker of muscle wasting, reflective of denervation and nutritional depletion, while lipid and retinol-binding protein alterations highlight non-nutritional disease mechanisms that may confound standard biomarker interpretation, informing more targeted nutritional assessments. These findings support a multimodal approach to nutritional monitoring in MND and emphasise the importance of accounting for inflammatory status in biomarker interpretation. Given the small sample size and the limited representation of non-ALS phenotypes, these findings should be regarded as hypothesis-generating and require confirmation in larger, multicentre cohorts with balanced phenotypic representation.
Background/Objectives: Cesarean delivery has been linked with breastfeeding difficulties. However, the mechanistic pathways underlying these challenges remain incompletely understood. This systematic review aimed to synthesize evidence regarding the physiological, clinical, psychological, and health system-related mechanisms contributing to breastfeeding challenges following cesarean delivery. Methods: A systematic search was conducted in PubMed/MEDLINE and Scopus for studies published between 2020 and 2026. Studies with observational, interventional, and qualitative designs that examined breastfeeding challenges following cesarean delivery were eligible. A theory-informed narrative synthesis was applied, categorizing challenges into physiological, clinical, psychological, and health system domains and integrating them into a pathway-based conceptual framework. Results: Twenty-six studies were included. Across heterogeneous study designs, commonly reported breastfeeding challenges included delayed lactogenesis, postoperative pain and functional limitations, difficulties with early mother–infant interaction, concerns regarding human milk sufficiency, reduced breastfeeding self-efficacy, and variability in postpartum breastfeeding support. These findings were organized into physiological, clinical, psychological, and health-system domains. Cross-study synthesis suggested potential interactions among these domains, particularly involving delayed breastfeeding initiation, breastfeeding difficulties, lactation-related concerns, maternal perceptions, and subsequent feeding decisions. However, the proposed relationships were not uniformly tested within individual studies. Intervention studies suggested that strategies including skin-to-skin contact, breastfeeding counseling, and enhanced lactation support may improve selected breastfeeding outcomes. Conclusions: The findings suggest that breastfeeding challenges following cesarean delivery may involve interconnected biological, behavioral, clinical, and health-system factors. Understanding these mechanisms is essential for developing supportive and context-sensitive interventions that optimize breastfeeding establishment while maintaining adequate infant nutrition.
Background/Objectives: Stress is increasingly recognized as an important modulator of gut microbiome composition and function through the bidirectional microbiota–gut–brain axis. Dietary, psychobiotic, and other lifestyle-oriented interventions have therefore attracted growing interest as potential strategies for simultaneously influencing stress-related outcomes and the gut microbiome. This systematic review aimed to evaluate randomized controlled trials (RCTs) investigating the effects of lifestyle-oriented and psychobiotic interventions on both stress-related outcomes and the gut microbiome in adults. Methods: A systematic literature search was conducted in PubMed, Scopus, and Cochrane CENTRAL for English-language RCTs published between 2016 and April 2026, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Eligible studies included adults (≥18 years), evaluated lifestyle-oriented or psychobiotic interventions, and reported both gut microbiome-related and stress-related psychological or biological outcomes. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Owing to substantial methodological and clinical heterogeneity, findings were synthesized narratively. Results: Twenty-nine RCTs met the eligibility criteria. Interventions included psychobiotic supplementation, dietary interventions and functional foods, and other lifestyle-oriented approaches. Across intervention categories, microbiome responses were heterogeneous, and no single taxonomic or diversity signature consistently characterized trials reporting favorable stress-related outcomes. Nevertheless, recurrent changes involving Bifidobacterium/Bifidobacteriaceae, Lactobacillus/Lactobacillaceae, Faecalibacterium, Roseburia, and members of the Lachnospiraceae/Ruminococcaceae families were identified across several interventions, together with changes in SCFA-related microbial features. Changes in global microbial diversity were inconsistent, and psychological and microbiome responses did not invariably occur in parallel. Overall, the randomized evidence indicates recurrent taxonomic and functional signals rather than a uniform microbiome response across stress-targeting interventions. Substantial heterogeneity in populations, intervention characteristics, study duration, outcome measures, and microbiome assessment methods limited direct comparisons across trials. Conclusions: Current randomized evidence does not identify a uniform microbiome signature associated with successful stress-targeting interventions but suggests partial convergence involving selected bacterial taxa and functional microbial features. The lack of consistent parallel changes in psychological and microbiome outcomes precludes conclusions regarding whether microbiome alterations mediate improvements in stress-related outcomes. Larger, longer-term RCTs incorporating standardized microbiome methodologies and functional microbial analyses are needed to determine the reproducibility and mechanistic relevance of these signals.
Background: An optimal 25OHD level can prevent osteopenia of prematurity (bone health) and premature delivery (non-skeletal activity). Although maternal and fetal vitamin D (25OHD) levels correlate, data on preterm infants’ 25OHD status at birth are limited, with a well-recognized deficiency among term infants. Objectives: To evaluate maternal and neonatal 25OHD status at preterm birth and its determinants in a northern-latitude country, Poland. Design/Methods: Cross-sectional study between August 2015 and September 2016 investigating cord and maternal blood 25OHD levels at delivery in 69 pairs of mothers and newborns ≤ 32 6/7 weeks of gestation, and analyzing correlations between maternal and neonatal 25OHD levels and their influencing factors, with univariable and multivariable linear regression. Results: Median (IQR) 25OHD levels were 25 (16.6–34 ng/mL) in cord blood and 21.2 (15–29 ng/mL) in mothers and correlated positively (r = 0.69, p < 0.0001). 25OHD insufficiency was detected in 84.06% of mothers and 62.32% of newborns. Maternal 25OHD levels were higher in summertime delivery (p = 0.0008). The rate of vitamin D supplementation during pregnancy was 54.4%, increasing maternal (27 ng/mL vs. 16.7 ng/mL, p = 0.0006), cord blood (32.4 ng/mL vs. 17.4 ng/mL, p = 0.0005), and summer seasonal cord blood 25OHD levels (38.89 ng/mL vs. 25.5 ng/mL, p = 0.023), and the percentage of maternal (72.7% vs. 27.3%, p = 0.005) and neonatal 25OHD sufficiency (80% vs. 20%, p = 0.0021). Conclusions: Vitamin D insufficiency is common in mothers and their prematurely born infants at birth; vitamin D supplementation reverses the trend. To avoid inadequate supplementation in preterm newborns and in mothers at risk of preterm delivery, regular assessment of 25OHD levels should be considered.
Background: Autistic traits are overrepresented among individuals with anorexia nervosa (AN) and are associated with greater eating disorder (ED) psychopathology, psychological distress, and work and social functioning difficulties in this population. However, less is known about the prevalence and clinical associations of autistic traits in other ED presentations, such as bulimia nervosa (BN). This study examined the prevalence of autistic traits and their associations with ED psychopathology, psychological distress, and work and social functioning difficulties in a transdiagnostic ED sample. Methods: A retrospective cross-sectional analysis was conducted using routinely collected clinical data of adults attending a specialist ED service with restrictive AN (AN-R), binge–purge AN (AN-BP), BN, binge eating disorder (BED), atypical AN (A-AN), or avoidant/restrictive food-intake disorder (ARFID). Prevalence rates of elevated autistic traits (AQ-10 ≥6) were described across diagnoses. Multiple linear-regression analyses examined associations between autistic traits and measures of eating disorder psychopathology, psychological distress, and work and social functioning difficulties. Results: Elevated autistic traits were reported by 40.0% of patients with ARFID, 34.2% with AN-BP, 31.9% with AN-R, 27.0% with BN, 26.4% with A-AN, and 16.7% with BED. Higher AQ-10 scores were significantly associated with greater ED psychopathology, psychological distress, and work and social functioning difficulties across the AN-R, BN, and full samples. In the AN-R and full samples, the associations remained significant across all models after controlling for age, gender, and ED duration. In the BN sample, all associations remained significant following adjustment except for ED psychopathology, which was no longer significant after controlling for ED duration. Conclusions: Autistic traits are elevated across multiple ED diagnoses and are associated with greater clinical severity. The findings support the clinical relevance of autistic traits across ED presentations and support the need for further investigation of autism-informed approaches across transdiagnostic ED services.
Natural products have historically represented an important source of bioactive molecules with applications in nutrition, health promotion, and disease management [...]
Vitamin D has been linked to beneficial effects across more than 100 health outcomes, generating substantial interest in its extraskeletal functions. However, because nutrients differ fundamentally from pharmaceuticals in biology and mechanisms of action, conventional pharmaceutical-style randomized controlled trials (RCTs) are often inappropriate for evaluating nutrient efficacy. Instead, well-designed observational studies that have assessed serum 25-hydroxyvitamin D [25(OH)D] concentrations and correlated them with biologically relevant clinical outcomes provide evidence of effectiveness and establish causality. Since vitamin D primarily acts as a preventive agent for chronic diseases, the strongest evidence is derived from large, long-term, ecological and prospective cohort studies. In contrast, many RCTs have failed to demonstrate significant benefits because of methodological limitations, including enrollment of vitamin D-sufficient participants, inadequate dosing regimens, vitamin D supplementation in control groups, short intervention periods, and analyses based on assigned dose rather than serum 25(OH)D concentrations achieved, which determine biological responses. Early ecological studies demonstrated inverse associations between solar ultraviolet B doses and the risks of cancer, cardiovascular disease (CVD), and infectious diseases. These findings have been consistently supported by numerous prospective larger cohort studies linking higher serum 25(OH)D concentrations with improved health outcomes. Observational studies also offer important advantages, including being large and covering diverse populations, wide variations in vitamin D status, longer follow-up, and adjustment for multiple confounding factors. When interpreted within a biological framework using Bradford Hill’s criteria for causality—including consistency, strength and temporality of associations, dose–response relationships, biological plausibility, mechanistic evidence, coherence, and experimental support—the accumulated evidence strongly supports causal relationships that vitamin D sufficiency reduces risks of several diseases. This narrative review critically evaluates the evidence for cancer, CVD, blood pressure, COVID-19, type 1 and type 2 diabetes, periodontal disease, multiple sclerosis, and dementia. For these diseases, the authors concluded that the evidence satisfies Hill’s criteria for causality and aligns with current understanding of vitamin D biology and nutrient–health relationships.
Background: Malnutrition is a significant clinical problem in patients with cancer, occurring not only during hospitalization but also throughout the recovery phase. It brings severe health and economic consequences, affecting patients on both physical and psychological levels. The American Society for Parenteral and Enteral Nutrition (ASPEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN) emphasize the critical importance of early detection of nutritional disorders and timely intervention in oncology populations. The aim of this study was to determine the prevalence of malnutrition and factors associated with malnutrition among hospitalized Polish oncology patients and to draw attention to the need for early nutritional assessment in patients with cancer so as to ensure appropriate nutritional care. Methods: A multicenter cross-sectional study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines among adult patients diagnosed with cancer and undergoing oncological treatment. Data collection involved a structured survey questionnaire, anthropometric measurements, and validated screening tools: Mini Nutritional Assessment (MNA), Nutritional Risk Screening Score 2002 (NRS 2002), and Subjective Global Assessment (SGA). Results: The study group comprised 560 patients with a mean age of 55 ± 13.95 years, including 59% women and 41% men. The mean duration of illness was 3.37 years. Advanced-stage cancer was present in 43% of participants, and 66% were undergoing chemotherapy. The mean Body Mass Index (BMI) for the study group was 23.14 kg/m2, with a mean MNA score of 16.23 points and a mean NRS 2002 score of 2.39 points. Based on Subjective Global Assessment, moderate malnutrition was identified in 45% of patients, whereas severe malnutrition was confirmed in 27% of the study population. Conclusions: The prevalence of malnutrition among oncology patients is high. Early screening and regular monitoring are essential for the prompt identification of patients at risk, enabling the implementation of appropriate nutritional therapy and the improvement of clinical outcomes.
Background/Objectives: Fatty acids (FAs) are critical mediators of human physiology, yet associations between dietary intake, circulating FA levels, and health outcomes remain debated. Circulating FAs are typically reported as a percentage of total FA (% total), whereas absolute concentrations are measured infrequently. Although mathematically related, these metrics provide distinct information. NHANES 2011–2012 uniquely provided serum FA concentrations, enabling direct comparison of concentration and % total within the same individuals. Methods: Serum FAs measured by electron capture negative-ion mass spectrometry in NHANES 2011–2012 were expressed as both absolute concentrations (µmol/L) and % total. Associations of each representation with lipid and non-lipid cardiometabolic biomarkers were evaluated and compared with total FA concentrations. Results: For multiple FAs and biomarkers, the direction of association differed depending on whether FAs were expressed as concentration or % total. These reversals occurred when total FAs varied more strongly with the biomarker than the individual FA concentration, allowing a FA to increase in absolute concentration while decreasing as a percentage of the total FA pool. Reversals were observed for several major FAs, including linoleic acid (LA), arachidonic acid (ARA), docosapentaenoic acid (DPA), docosahexaenoic acid (DHA), and stearic acid (SA). Total FA concentrations were strongly associated with most biomarkers. Conclusions: FA concentrations and % total are complementary, not interchangeable, measures that capture distinct aspects of circulating FA biology. Associations with outcomes can be in opposite directions when the total plasma FA pool varies. These differences reflect underlying mathematical and biological relationships rather than methodological error. Future studies should routinely evaluate the total FA pool size alongside FA composition. Examining both representations alongside total FA can help distinguish changes in absolute FA abundance from changes in relative composition and provide a more complete interpretation of FA associations.
Background/Objectives: Adequate dietary intake is essential for supporting growth, health, and athletic performance in adolescent athletes. Handball is a high-intensity intermittent team sport characterised by repeated running, sprinting, jumping, and physical contact, placing substantial physiological and nutritional demands on young athletes. This study examined associations between eating behaviour dimensions, sport anxiety, resilience, and dietary intake in adolescent elite female handball players. Methods: This cross-sectional study included 74 adolescent elite female handball players; after exclusion of two dietary-intake outliers, 72 participants were included in the analyses (mean age: 15.6 ± 1.7 years; BMI: 21.2 ± 2.4 kg/m2). Eating behaviour, sport anxiety, and resilience were assessed using the TFEQ-R21, SAS-2, and CD-RISC-10, respectively. Dietary intake was estimated using a semi-quantitative food frequency questionnaire. Pearson correlation and linear regression analyses were performed. Results: Cognitive Restraint was negatively correlated with energy (r = −0.266, p = 0.024), fat (r = −0.288, p = 0.014), carbohydrate (r = −0.257, p = 0.029), and sugar intake (r = −0.255, p = 0.031). Uncontrolled Eating was positively associated with energy (β = 0.338, p = 0.030; R2 = 0.134) and fat intake (β = 0.366, p = 0.017; R2 = 0.157) in the regression analyses. Higher resilience was associated with lower sugar intake in the regression analysis (β = −0.318, p = 0.007; model R2 = 0.101) and with lower sport anxiety in the Pearson correlation analysis (r = −0.559, p < 0.001). Conclusions: The findings indicate associations between eating behaviour dimensions, selected psychological characteristics, and dietary intake in adolescent elite female handball players. Uncontrolled Eating and Cognitive Restraint showed distinct patterns of association with dietary intake, while resilience was associated with sugar intake and sport anxiety. Given the cross-sectional and exploratory nature of the study, these findings warrant cautious interpretation and replication in larger independent samples.
Background/Objectives: Exclusive breastfeeding (EBF) is associated with multiple individual, interpersonal, and healthcare-related factors. Identifying potentially modifiable factors associated with EBF across different levels of influence may help inform future breastfeeding research and support strategies. This study aimed to identify individual, interpersonal, and obstetric factors associated with exclusive breastfeeding among Polish mothers, using the Socio-Ecological Model (SEM) as a conceptual framework. Methods: A cross-sectional online survey was conducted among 769 Polish mothers of children aged up to 24 months. The questionnaire included sociodemographic and perinatal characteristics, as well as standardized instruments: Multidimensional Scale of Perceived Social Support (MSPSS), Iowa Infant Feeding Attitudes Scale (IIFAS), and Birth Satisfaction Scale–Revised (BSS-R). Hierarchical binary logistic regression was used to identify factors associated with exclusive breastfeeding. Missing data were handled using multiple imputation by chained equations, with 20 imputed datasets, and estimates were pooled according to Rubin’s rules. Results: Exclusive breastfeeding was reported by 610 participants (79.3%). Across the 20 imputed datasets, the final model showed χ2 values ranging from 62.92 to 70.00 and Nagelkerke’s R2 values ranging from 0.123 to 0.136. In the final model, mode of delivery (OR = 1.92, 95% CI: 1.32–2.80, p < 0.001), complications/illnesses during pregnancy (OR = 1.73, 95% CI: 1.14–2.64, p = 0.011), and partner encouragement (OR = 2.81, 95% CI: 1.72–4.59, p < 0.001) were significantly associated with exclusive breastfeeding. A nonlinear association between breastfeeding attitudes and exclusive breastfeeding was observed, with the quadratic IIFAS term remaining statistically significant (OR = 0.99, 95% CI: 0.99–1.00, p = 0.002), whereas the linear IIFAS term was not statistically significant in the final model (OR = 1.04, 95% CI: 1.00–1.08, p = 0.078). Birth satisfaction and the MSPSS Friends, Family, and Significant Other subscales were not independently associated with exclusive breastfeeding in the final model. Conclusions: Among the variables included in the final model, partner encouragement showed the strongest association with exclusive breastfeeding. Mode of delivery and complications/illnesses during pregnancy were also associated with exclusive breastfeeding, while the association between breastfeeding attitudes and exclusive breastfeeding was nonlinear. These findings may inform future prospective and intervention studies examining partner support, breastfeeding attitudes, and perinatal factors in relation to exclusive breastfeeding. Further research is warranted to explore the mechanisms underlying the observed associations.
Background/Objectives: This study evaluated changes in PMS severity, nutrition knowledge, and eating attitudes over a 6-week online nutrition education programme delivered to female university students. Methods: This uncontrolled single-arm pretest/posttest study included 112 female university students recruited by convenience sampling from a women’s dormitory. Nutrition education was delivered daily for 6 weeks via WhatsApp as 42 informational cards. Measurements were taken before and after the programme. Attitudes and behaviours associated with disordered eating were screened using the Eating Attitudes Test-26 (EAT-26), nutrition knowledge using the Nutrition Knowledge Level Scale for Adults (NKLSA), and premenstrual symptom severity using the Premenstrual Syndrome Scale (PMSS). Results: No significant changes occurred in nutrition knowledge (p = 0.409) or eating attitudes (p = 0.654). The PMSS score significantly decreased (mean change = 14.28 ± 46.34; 95% CI 5.60–22.96; p = 0.001, dz = 0.31, 95% CI 0.12–0.50), with decreases across eight subscales (dz = 0.19–0.38; BH q < 0.05), whereas appetite changes were unchanged (p = 0.423); the largest standardized changes were observed for depressive mood and bloating. PMSS change was not correlated with knowledge (r = 0.001) or knowledge with eating attitudes (r = 0.057); PMSS and eating attitude changes were weakly positively correlated (r = 0.187, p = 0.048; exploratory, not corrected for multiplicity). Conclusions: Following a 6-week WhatsApp-based nutrition education programme, self-reported PMS severity decreased, particularly mood and somatic symptoms, without changes in nutrition knowledge or eating attitudes. The uncontrolled single-arm design precludes attributing these changes to the programme.
Background/Objectives: Although paraprobiotics and postbiotics may beneficially affect glucose metabolism, their direct influence on intestinal glucose transporters remains poorly understood. This study investigated the in vitro effects of selected heat-killed Lactobacillaceae strains and cell-free supernatants from their viable counterparts on sodium-driven glucose cotransporter 1 (SGLT1) and facilitative glucose transporter 2 (GLUT2) expression and basolateral glucose accumulation. Methods: Experiments were performed using non-carcinogenic porcine-derived enterocytes (CLAB) and human epithelial colorectal adenocarcinoma cells (Caco-2; ATCC HTB-37). SGLT1 and GLUT2 gene and protein expression, as well as basolateral glucose concentration after a 6-h incubation, were assessed. Results: Heat-killed probiotics and cell-free probiotic supernatants generally increased SGLT1 protein expression in both cell models, except for heat-killed Lactobacillus acidophilus. In contrast, GLUT2 modulation differed between cell models and treatments. In CLAB cells, GLUT2 protein levels were generally reduced, particularly following exposure to cell-free probiotic supernatants, whereas responses in Caco-2 cells were less consistent. Treatment-dependent changes in basolateral glucose concentration and 6-h net basolateral glucose accumulation were also observed, with significant effects for selected heat-killed strains in CLAB cells. Conclusions: Lactobacillaceae-derived heat-killed preparations and cell-free supernatants may differentially modulate intestinal glucose transporter expression in a strain- and cell-model-dependent manner. However, changes in transporter expression and basolateral glucose accumulation do not establish a transporter-specific glucose flux or mechanism. Further mechanistic studies using complementary intestinal models are required to clarify these effects and their translational relevance.
Background/Objectives: Diet quality among Mexican-born immigrant women may be influenced by food security (FS) and neighborhood food environment factors; however, these relationships remain understudied. This exploratory study examined differences in diet quality/dietary outcomes by FS status and explored the potential for perceived neighborhood food availability to modify the association between FS and diet quality. Methods: Mexican-born immigrant women (n = 57) self-reported FS, diet, and perceived neighborhood food availability. Diet was assessed using the Southwest Food Frequency Questionnaire to calculate the Healthy Eating Index (HEI-2020) score. The six-item USDA FS Scale was used to dichotomize FS as high or low. Independent t-tests assessed differences in HEI-2020; fast-food frequency; and intake of fruit, vegetables, salty snacks, and sugar by FS status. An exploratory regression analysis examined whether perceived food availability modified the association between FS and diet quality using complementary Bayesian techniques to improve efficiency given the small sample size. Results: Women experiencing low FS had lower HEI-2020 than those with high FS (62 ± 8 vs. 66 ± 6; p = 0.03), as well as non-significantly lower intakes of fruit (236 ± 178 vs. 294 ± 239 g), vegetables (303 ± 188 vs. 331 ± 199 g), and salty snacks (6 ± 5 vs. 8 ± 10 g) and higher intakes of sugar (99 ± 55 vs. 96 ± 56 g) and fast food (2.5 ± 2.5 vs. 1.8 ± 1.7 times/month). No statistically significant evidence of the perceived neighborhood food availability modifying the association between FS and diet quality was observed. Exploratory analysis suggested that among women experiencing low FS, HEI-2020 score varied by perceived neighborhood food availability (low: 57; moderate: 61; high: 65; p = 0.077). Bayesian analyses suggested a greater impact of perceived neighborhood food availability among women with low FS and lower diet quality. Conclusions: In this small sample of Mexican-born women, low FS was associated with lower diet quality. Although evidence of effect modification by perceived neighborhood food availability was not observed, exploratory findings suggest that it may influence diet quality among women experiencing low FS and warrant investigation in larger studies.
Background/Objectives: Diet is a modifiable determinant of kidney health, and sex differences in kidney physiology support sex-specific evaluation of dietary patterns. We examined the association of Planetary Health Diet Index (PHDI) adherence with cystatin C-based eGFR decline, and its modification by sex, in US adults aged 50 years and older. Methods: We analyzed 2126 Health and Retirement Study participants (950 men, 1176 women) with diet assessed by food frequency questionnaire in 2013 and cystatin C-based eGFR measured in 2012 and 2016. Survey-weighted regression models, adjusted for baseline eGFR and for demographic, socioeconomic, lifestyle and clinical covariates, related PHDI to eGFR change and to a ≥30% relative eGFR decline; sex interaction was tested on the multiplicative and additive scales. Results: PHDI adherence was nonsignificantly associated with lower eGFR decline (β per 10-point increment 0.218; 95% CI −0.065 to 0.466). Among women, each 10-point-higher score was associated with slower eGFR decline (β 0.355; 95% CI 0.029 to 0.681; p = 0.034) and 20% lower odds of ≥30% eGFR decline (OR 0.799; 95% CI 0.687 to 0.930; p = 0.005); no significant association was observed in men (β 0.080; 95% CI −0.294 to 0.454; OR 1.080; 95% CI 0.901 to 1.295). Sex modified the association with ≥30% eGFR decline on both a multiplicative (p = 0.002) and additive scale (p < 0.001). Conclusions: PHDI adherence was associated with slower kidney function decline in women aged 50 years and older, with non-significant effect in men. Sex merits consideration as a biological modifier when plant-forward diets are evaluated as potentially nephroprotective strategies.
Background/Objectives: The intake of bread has been associated with gastrointestinal discomfort in some individuals. The primary aim of this study was to investigate gut symptoms upon consuming sourdough bread compared to baker’s yeast bread. Secondary endpoints were changes in targeted gut microbial taxa, micronutrient levels, and metabolic markers. Methods: This randomised, controlled, double-blind cross-over study included twenty healthy participants. Sourdough or baker’s yeast bread was consumed for one week before crossing over. Before and after the interventions, participants reported gut symptoms, and they also provided blood samples to analyse micronutrients, metabolic markers, and faecal samples for targeted gut microbial taxa analyses. Results: The breads were made of whole grain wheat with similar macronutrients content. The sourdough bread contained less fructose than the baker’s yeast bread. The consumption of sourdough bread caused a significant reduction in the diarrhoea sub-dimension score (p = 0.016) and a borderline significant reduction in the overall GSRS-IBS score compared to baker’s yeast (p = 0.051). Several gut bacteria were significantly increased after intake of sourdough bread compared to baker’s yeast bread: Alistipes putredinis (p = 0.029), Alistipes shahii (p = 0.015), Bifidobacterium adolescentis (p = 0.042), Bifidobacterium longum (p = 0.010) and Bifidobacterium longum subspecies longum (p = 0.021). There was a significant correlation between changes in diarrhoea score and changes in Alistipes shahii (r= −0.353, p = 0.025). Conclusions: This exploratory cross-over study did not demonstrate a statistically significant difference in the overall GSRS-IBS score between the two breads. A nominal difference in the diarrhoea sub-dimension and selected targeted microbial taxa was observed between the two breads, but these findings require further investigations.
Background/Objectives: Highly branched cyclic dextrin (HBCD) may improve carbohydrate (CHO) availability during soccer-specific intermittent exercise via favorable gastrointestinal properties. Whether co-ingestion with whey protein confers additional ergogenic benefits beyond HBCD alone remains unclear. Methods: Nine male soccer players completed a single-blind, randomized crossover trial (≥7-day washout) with three conditions, Placebo (water), CHO, and isocaloric HBCD plus whey protein isolate (CHOP), during a standardized, ~120-min laboratory-based soccer-specific intermittent exercise protocol (not an actual match). The 500-mL beverage, split into two 250-mL servings, was consumed before exercise and at half-time during the exercise protocol. Respiratory quotient (RQ), substrate oxidation, heart rate, RPE, digestive symptoms, running time, and distance were assessed, with condition effects tested via repeated-measures ANOVA at each cycle. Results: Compared with Placebo, CHO increased RQ (p = 0.042) and carbohydrate oxidation (p = 0.048) while reducing fat oxidation (p = 0.034) at the final cycle, reflecting greater late-exercise CHO utilization without improving endurance performance. Compared with Placebo, CHOP significantly improved both running time (p = 0.019) and running distance (p = 0.025), with no significant difference from CHO on either outcome. RPE was significantly lower in CHOP than in Placebo during the latter stage of exercise (p = 0.016). Conclusions: HBCD ingestion before exercise and at half-time promoted greater late-exercise CHO utilization without increasing cardiovascular or gastrointestinal strain. Co-ingestion of whey protein with HBCD provided ergogenic benefits over Placebo by improving fatigue-limited endurance performance, supporting isocaloric CHOP co-ingestion as a practical nutritional strategy for prolonged soccer-specific intermittent exercise.
